Challenges faced by nurses in managing pain in a critical care setting.

Subramanian, P. and Allcock, N. and James, V. and Lathlean, J. (2011) Challenges faced by nurses in managing pain in a critical care setting. Journal of Clinical Nursing. ISSN 1365-2702

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Aim.  To explore nurses' challenges in managing pain among ill patients in critical care. Background.  Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Design.  Qualitative prospective exploratory design. Methods.  This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Results.  Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Conclusions.  Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. Relevance to clinical practice.  There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines.

Item Type: Article
Additional Information: Authors: Pathmawathi Subramanian, DHSci, Med, RN, Lecturer, Department of Nursing Science, University of Malaya, Kuala Lumpur, Malaysia; Nick Allcock, PhD, RGN, Dip Ed, Associate Professor and Co Director of The Nottingham Centre for Evidence Based Nursing and Midwifery (a collaborating centre of the Joanna Briggs Institute), University of Nottingham School of Nursing, Midwifery and Physiotherapy, Queens Medical Centre; Veronica James, MA, PhD, RGN, Professor of Nursing and Centre Director, JBI Nottingham Collaborating Centre, University of Nottingham School of Nursing, Midwifery and Physiotherapy, Queen's Medical Centre, Nottingham; Judith Lathlean, BSc, MA, DPhilm, Professor of Health Research, Head of Postgraduate Research Students and Acting Head of Organisation & Delivery of Care (ODC) Research Group, School of Health Sciences, University of Southampton, Highfield, Southampton, UK
Uncontrolled Keywords: Nursing
Subjects: R Medicine > RT Nursing
Depositing User: Mr. Faizal Hamzah
Date Deposited: 01 Aug 2011 06:55
Last Modified: 01 Aug 2011 06:55

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