Nurses' perceived barriers to optimal pain management in older adults on acute medical units☆
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.
aSchool of Nursing, McMaster University, Hamilton, ON, Canada L8N 3Z5
bSt. Peter’s Hospital, Hamilton, ON, Canada L8M 1W9
cDepartment of Medicine, Division of Geriatric Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
dHamilton Health Sciences, Box 2000, Hamilton, ON, Canada L8N 3Z5
eDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
fCentre for Evaluation of Medicines, St. Joseph’s Healthcare, Hamilton, ON, Canada L8N 1G6
gSt. Joseph’s Centre for Ambulatory Health Services, Hamilton, ON, Canada L8G 5E4
hDivision of Palliative Care, McMaster University, Hamilton, ON, Canada L8N 3Z5
Corresponding author. St. Peter's Hospital, Hamilton, ON L8M 1W9, Canada. Tel.: +1 905 777 3837x12227.
☆ 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.
ABSTRACT