Staff nurses' perceptions of barriers to effective pain management

The purpose of this study was to investigate staff nurses' perceptions of barriers to pain management including lack of educational preparation; inadequacy of clinical practice skills; and certain legal/political, financial, and ethical problems. Staff nurses rated the adequacy of their knowledge and skills in each of these areas as well as how important they believed each area was on a four-point Likert scale (1 = very inadequate or very unimportant to 4 = very adequate or very important). Nurses were also asked to list the most important pain management problems in their institutions. A random sample of 24 hospitals stratified on the basis of size was drawn from four states in the United States. Of 125 nurses contacted, 108 (86%) responded to the questionnaire. Nurses rated their educational preparation (mean, 2.6; SD, 0.05) and knowledge of legal/political issues (mean, 2.3; SD, 0.05) midway between inadequate and adequate. Practice was rated as adequate (mean 3.1; SD, 0.36), and financial issues were rated as inadequate (mean, 1.9; SD, 0.06). Knowledge of ethical issues was adequate (mean, 3.1; SD, 0.03). Implications of these ratings based on the literature in pain management are discussed.