Barriers to pediatric pain management: a nursing perspective

Area of Science:

• Pediatric Nursing
• Pain Management
• Healthcare Quality Improvement

Background:

• Optimal pain management is essential for pediatric patient care.
• Identifying and addressing barriers is critical for improving nursing practice.
• The Joint Clinical Practice Council sought to understand nurse-perceived obstacles to pain management.

Purpose of the Study:

• To identify barriers perceived by registered nurses (RNs) that interfere with optimal pain management in pediatric patients.
• To gather RN perspectives on optimal pain management and perceived obstacles.
• To inform the development of targeted interventions to overcome identified barriers.

Main Methods:

• A survey, adapted from "Barriers to Optimal Pain Management" (Van Hulle Vincent & Denyes, 2004), was administered to RNs across all patient care settings.
• Two hundred seventy-two surveys were returned and analyzed to identify significant barriers.
• Narrative comments were also collected to provide additional qualitative insights.

Main Results:

• The five most significant barriers identified were: insufficient physician (MD) orders, insufficient MD orders before procedures, insufficient time for pre-procedure medication, perceived low priority of pain management by medical staff, and parental reluctance to administer pain medication.
• Additional barriers were identified through qualitative analysis of narrative comments.
• The study also explored the impact of the Acute Pain Service and RNs' perceptions of current pain management.

Conclusions:

• Significant barriers to optimal pediatric pain management exist, primarily related to physician orders, time, and interprofessional communication.
• Addressing these identified barriers through specific interventions is necessary to enhance pain management practices.
• Improving pain management requires a multi-faceted approach involving healthcare providers, staff, and parents.