The knowledge and attitudes of nonanesthesia nurses regarding postoperative epidural analgesia

The provision of epidural analgesia for postoperative pain control offers many patient benefits and has become commonplace on many nursing units. Since nurses are responsible for the day-to-day management of patients receiving epidural analgesia, their knowledge, attitudes, and practices regarding this technique are pivotal to its success. Therefore, the purpose of the present descriptive study was to examine the knowledge base, attitudes, and clinical practice of registered nurses (N = 85) regarding postoperative epidural analgesia as managed by an acute pain service (APS). Information was obtained from a survey distributed via a convenience sample to all nurses working on 6 units in a large military teaching facility. We developed the "Epidural Knowledge and Attitude Survey" using the nursing literature on epidural analgesia. The survey consisted of a demographics section, true/false (T/F) questions, multiple choice (M/C) questions, an attitude section, and a comment section. These sections addressed the nurses' knowledge, attitudes, and practices in regard to epidural pharmacology, management, and adverse effects, as well as their general satisfaction with the APS of their facility. Data were analyzed statistically using means, standard deviations, percentages, forward step-wise linear regression, the Fisher-Irwin (exact) test, the chi 2 test, and analysis of variance with Bonferroni multiple comparisons. A P value of < .05 was considered statistically significant. Results of the study demonstrated that the respondents attained a 78% overall correct score on T/F questions and 38% on M/C questions. The attitude section illustrated that 73% of nurses had "positive" attitudes toward epidural analgesia. Correct management of patients receiving epidural analgesia was being practiced by 77% of nurses. The satisfaction with the APS at this facility was 32% "very satisfied" and 62% "somewhat satisfied." The demographic characteristics that best predicted a higher score on the knowledge portion of the survey were greater years of practice as a nurse and receipt of pain education in nursing training. Nurses who had received inservice education about epidural analgesia rated a "good" self-knowledge of epidurals more often (40%) than those who did not (10%) and scored significantly higher on the knowledge portion of the survey.