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The Effect of a Pain Management Empowerment Program on Nursing Care Quality in Pediatric ICUs: A Quasi-Experimental
Zhila Tahmasb Zamanian1, FatemehSadat SeyedNematollah Roshan1, Narges Rahmani2
1Department of Nursing, TeMS. C., Islamic Azad University, Tehran, Iran, azad.ac.ir.
Objective:
High-quality patient care relies on nurses' adherence to professional nursing standards. Effective pain management reduces disease severity, accelerates recovery, decreases the length of hospital stay, and improves care quality indicators. This study aimed to examine the effect of empowering nurses in pain management on the quality of care in pediatric intensive care units.
Methods:
This quasi-experimental study was conducted in two pediatric intensive care units in Tehran, Iran. Using a two-stage cluster randomization method, 60 nurses were allocated to test and control groups (30 per group). The intervention consisted of a structured pain management training program, including two 2-h theoretical sessions and one practical bedside session covering pediatric pain assessment, standardized pain scales, and evidence-based pain management strategies. Quality of nursing care was assessed at baseline and 1.5 months after the intervention using the QUALPAC questionnaire. Data were analyzed using SPSS Version 27 (p < 0.05).
Results:
At baseline, no significant differences were observed between the test and control groups in quality of care across physical, communication, and psychosocial dimensions (p > 0.05). After the intervention, the test group showed significant improvements in all dimensions: physical (86.73 ± 9.51 to 91.13 ± 8.62, d = 1.06), communication (43.43 ± 6.63 to 47.13 ± 4.89, d = 0.921), psychosocial (108.20 ± 13.30 to 123.70 ± 10.34, d = 1.56), and total quality of care (238.36 ± 27.00 to 261.26 ± 22.11, d = 1.53) (p < 0.001). No significant changes occurred in the control group (p = 0.06 - 0.584). Postintervention analyses revealed significant between-group differences in all care-quality dimensions and in total quality of care (p ≤ 0.05), with a higher proportion of participants reaching the completely favorable level in the test group.
Conclusions:
Nurse empowerment in pain management significantly improved the quality of care in pediatric intensive care units. These findings highlight the importance of structured educational interventions to enhance nursing performance in pain management.