Purpose: To describe nurses' knowledge and attitudes about relieving children's pain, perceived barriers to optimal pain management, and analgesics administered by nurses in relation to levels of children's pain.
Study design and methods: Data were collected from 67 nurses and 132 children in their care. Outcomes were measured with The Nurses' Knowledge and Attitudes Survey Regarding Pain, the Nurses' Perceived Barriers to Optimal Pain Management for Children Survey, calculations of the ordered analgesia administered by the nurse, and the Oucher scale for intensity of children's pain.
Results: Most nurses demonstrated knowledge and positive attitudes about relieving children's pain but lacked knowledge about the incidence of respiratory depression and thought that children overreport their pain. Inadequate or insufficient physician medication orders for pain were identified by 99% of nurses as the greatest barrier to optimal pain management. The children's mean pain level was 1.63 (scale of 0 to 5). Of the 117 children who reported pain, 74% received analgesia. Nurses administered means of 37.9% of available morphine and 22.8% of available total analgesia.
Clinical implications: Nurses in practice need to become more aware of the adequacy of their analgesic administration, the value of children's self-report of pain, and the limitations of relying on children's behavioral manifestations to judge pain intensity. This study also demonstrates the importance of examining attitudes about children's pain relief and learning more about respiratory depression in children receiving opioids.