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Why is pain management suboptimal on surgical wards?
E I Schafheutle1, J A Cantrill, P R Noyce
1School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK. ellens@fs1.pa.man.ac.uk
Journal of Advanced Nursing
|April 12, 2001
Summary
Nurses face significant barriers to effective pain management, including workload, staffing issues, and prescribing problems. Addressing both recognized and subconscious barriers is crucial for improving patient pain relief.
Area of Science:
- Nursing Practice
- Pain Management
- Healthcare Systems
Background:
- Nurses on surgical wards manage patient pain, particularly with as-needed (PRN) analgesics.
- Despite advanced analgesics and technology, suboptimal pain management persists.
Purpose of the Study:
- To identify perceived barriers to effective pain management in nursing practice.
Main Methods:
- Data collected via six nurse interviews and a survey of 180 nurses across 14 UK hospitals.
- Methods were informed by detailed observations of nurses on surgical wards.
Main Results:
- Nurses cited organizational issues (workload, staffing) and institutional constraints as barriers.
- Inadequate analgesic prescribing and unavailability of medical/pain teams were identified.
- Subconscious barriers included not asking about pain during drug rounds due to patient status (asleep, on epidural/PCA) or recent analgesia.
Conclusions:
- Two types of barriers to effective pain management were identified: recognized and subconscious.
- Both types of barriers require attention before implementing new pain management improvement systems.