Applied Nursing Research
Volume 23, Issue 3 , Pages 139-146, August 2010

Nurses' perceived barriers to optimal pain management in older adults on acute medical units☆

  • Esther Coker, MScN, MSc, RN, GNC(C)

      Affiliations

    • School of Nursing, McMaster University, Hamilton, ON, Canada L8N 3Z5
    • St. Peter’s Hospital, Hamilton, ON, Canada L8M 1W9
    • Corresponding Author InformationCorresponding author. St. Peter's Hospital, Hamilton, ON L8M 1W9, Canada. Tel.: +1 905 777 3837x12227.
    • ,
  • Alexandra Papaioannou, MSc, MD, FRCP(C), FACP

      Affiliations

    • Department of Medicine, Division of Geriatric Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
    • Hamilton Health Sciences, Box 2000, Hamilton, ON, Canada L8N 3Z5
    • ,
  • Sharon Kaasalainen, PhD, RN

      Affiliations

    • School of Nursing, McMaster University, Hamilton, ON, Canada L8N 3Z5
    • ,
  • Lisa Dolovich, PharmD

      Affiliations

    • Department of Family Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
    • Centre for Evaluation of Medicines, St. Joseph’s Healthcare, Hamilton, ON, Canada L8N 1G6
    • ,
  • Irene Turpie, MB, ChB, MSc, FRCP(C)

      Affiliations

    • Department of Medicine, Division of Geriatric Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
    • St. Joseph’s Centre for Ambulatory Health Services, Hamilton, ON, Canada L8G 5E4
    • ,
  • Alan Taniguchi, MD, CCFP

      Affiliations

    • Hamilton Health Sciences, Box 2000, Hamilton, ON, Canada L8N 3Z5
    • Department of Family Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
    • Division of Palliative Care, McMaster University, Hamilton, ON, Canada L8N 3Z5

Received 22 April 2008; received in revised form 2 July 2008; accepted 14 July 2008. published online 16 January 2009.

Abstract 

Nurses' perceptions of barriers preventing optimal pain management in older adults on acute medical units and the extent to which they perceived they had adopted four evidence-based practices related to pain assessment and management were often incongruent with actual practice. Eliciting reports of pain, offering pro re nata pain relief regularly, utilizing pain assessment tools in patients with cognitive impairment, redesigning documentation tools and processes, making nonpharmacological alternatives accessible, and helping patients and families manage side effects would target the 12 barriers having the biggest impact.

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☆ The authors wish to acknowledge the support of the Hamilton Health Sciences Foundation in partnership with The Canadian Nurses Foundation and The Canadian Gerontological Nursing Association. We also thank Sheri Burns, BA, for her support in data management and analysis.

PII: S0897-1897(08)00079-7

doi:10.1016/j.apnr.2008.07.003

Applied Nursing Research
Volume 23, Issue 3 , Pages 139-146, August 2010

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