Nurses' Perceptions and Attitudes Toward Use of Oral Patient-Controlled Analgesia

Patient-controlled analgesia (PCA) administered intravenously is a generally well-accepted therapy by nurses and patients. PCA devices are now available for oral medications, allowing patients to self-administer pain pills without requesting them from the nurse. Successful introduction of new pain medication delivery devices can depend on nurses' knowledge and attitudes. The aim of this institutional review board approved project was to evaluate nurses' perceptions and attitudes toward using an oral PCA device for patients' pain. A 4-week study was designed and conducted at an academic medical center on an orthopedic unit and a women's health unit. Nurse participants received education on using the oral PCA device and were invited to complete a pre- and poststudy knowledge and attitude survey regarding pain management. Nurses and patients also completed a questionnaire about perceptions related to using the oral PCA device. Findings showed that nurses' attitudes toward using the oral PCA device were less favorable than those of patients, suggesting that nurses may require additional education for acceptance of this device. Results from 37 nurses showed improvement in overall knowledge and attitudes, from 70.8% pretest to 74.2% post-test. Although improvement was not statistically significant (p = .1637), two items showed significant improvement. Knowledge about the effectiveness of NSAIDS was 27.5% pretest compared with 60.0% post-test (p = .0028); and understanding about use of opioids in patients with a history of substance abuse was 50% pretest compared with 70% post-test (p = .0531). Helping nurses overcome the perceived barriers to use of an oral PCA device has potential implications for better pain management as well as enhanced patient satisfaction.