Barriers and enablers of intensive care unit nurses' assessment and management of patients' pain

Abstract

Background: Inadequate pain assessment and management is a problem in hospitalized patients that impairs their well-being. Intensive care unit nurses' pain practices are affected by several barriers and enablers.

Aims and objectives: To explore intensive care unit nurses' pain education, perceived barriers, and enablers of pain assessment and management practices among critically ill patients.

Design: A cross-sectional descriptive design was used in the study.

Methods: Convenience sampling technique was used, including 300 nurses recruited from 22 intensive care units in Jordan. The Pain Assessment and Management for Critically Ill Adults Survey was used to collect data. Descriptive statistics, spearman correlation, and chi-square tests were used to analyse the data.

Results: Only 127 (42.3%) of the nurses reported moderate to extreme satisfaction about receiving professional development education related to pain among critically ill patients. Nurse workload (65.3%), patient instability (54.4%), patient inability to communicate (53.3%), and sedation interfering with pain assessment (50%) were reported by nurses as the most frequent barriers impacting pain assessment and management. Enablers of pain assessment and management reported most frequently were "pain assessment and management is a unit priority" (63.7%), "enthusiastic and motivated staff" (61.3%), "protocols and guidelines are in use" (57.4%), and "standardized assessment tools are in use" (57%). Some barriers and enablers to pain assessment and management and pain education differed significantly according to nurses' experience and hospital type.

Conclusion: This study identified a range of enablers and barriers to pain assessment and management practices perceived by intensive care unit nurses. Nurse workload was an important barrier while making pain assessments, and management a unit priority was an important enabler for pain assessment and management. Frequent assessment of barriers and enablers of pain assessment and management is needed in critical care units to improve nurses' practices. Pain education should be included in the hospitals' continuous educational program.

Keywords: barriers; education; enablers; intensive care nurses; pain assessment; pain control; pain education; pain management.