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 ,Revised 2 July 2008 ,Accepted 14 July 2008.

References 

  1. American Geriatrics Society (AGS) Panel on Persistent Pain in Older Persons . The management of persistent pain in older persons. Journal of the American Geriatrics Society. 2002;50:S205–S224
  2. Brassard M, Ritter D. Memory jogger II: A pocket guide of tools for continuous improvement and effective planning. Salem, NH: GOAL/QPC; 1994;
  3. Brett J. Use of nursing practice research findings. Nursing Research. 1987;36:344–349
  4. Coker E, Papaioannou A, Turpie I, Dolovich L, Kaasalainen S, Taniguchi A, et al. Pain management practices with older adults on acute medical units. Perspectives. 2008;32(1):5–12
  5. Dillman D. Mail and telephone surveys: The total design method. New York, NY: Wiley; 1978;
  6. Fox P, Solomon P, Raina P, Jadad A. Barriers and facilitators in pain management in long-term care institutions: A qualitative study. Canadian Journal on Aging. 2004;23:269–280
  7. Grimshaw J, Eccles M, Thomas R, MacLennan G, Ramsay C, Fraser C, et al. Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966–1998. Journal of General Internal Medicine. 2006;21:S14–S20
  8. Hadjistavropoulos T, Herr K, Turk D, Fine P, Dworkin R, Helme R, et al. An interdisciplinary expert consensus statement on assessment of pain in older persons. Clinical Journal of Pain. 2007;23:S1–S43
  9. Herr K, Coyne P, Key T, Manworren R, McCaffery M, Merkel S, et al. Pain assessment in the nonverbal patient: Position statement with clinical practice recommendations. Pain Management Nursing. 2006;7:44–52
  10. Herr K, Mobily P. Comparison of selected pain assessment tools for use with the elderly. Applied Nursing Research. 1993;6:39–46
  11. Herr K, Titler M, Schilling M, Marsh J, Xie X, Ardery G, et al. Evidence-based assessment of acute pain in older adults: Current nursing practices and perceived barriers. Clinical Journal of Pain. 2004;20:331–340
  12. Horgas A, Yoon S. Pain management. In:  Capezuti E,  Zwicker D,  Mezey M,  Fulmer T editor. Evidence-based geriatric nursing protocols for best practice. 3rd ed.. New York: Springer; 2008;p. 199–222
  13. Kaasalainen S, Coker E, Dolovich L, Papaioannou A, Hadjistavropoulos T, Emili A, et al. Pain management decision making among long-term care physicians and nurses. Western Journal of Nursing Research. 2007;29:561–580
  14. Martin R, Williams J, Hadjistavropoulos T, Hadjistavropoulos H, MacLean M. A qualitative investigation of seniors' and caregivers' views on pain assessment and management. Canadian Journal of Nursing Research. 2005;37:142–164
  15. Registered Nurses Association of Ontario (RNAO) . Assessment and management of pain. Toronto, ON: Registered Nurses Association of Ontario; 2002;
  16. Registered Nurses Association of Ontario (RNAO) . Toolkit: Implementation of clinical practice guidelines. Toronto, ON: Registered Nurses Association of Ontario; 2002;
  17. Rogers E. Diffusion of innovations. New York, NY: The Free Press; 1995;
  18. Rutledge D, Greene P, Mooney K, Nail L, Ropka M. Use of research-based practices by oncology staff nurses. Oncology Nursing Forum. 1996;23:1235–1244
  19. Tague N. The quality toolbox. 2nd ed.. Milwaukee, WI: ASQ Quality Press; 2004;
  20. Tarzian A, Hoffmann D. Barriers to managing pain in the nursing home: Findings from a statewide survey. Journal of the American Medical Directors Association. 2004;5:82–88
  21. Titler M, Herr K, Schilling M, Marsh J, Xie X, Ardery G, et al. Acute pain treatment for older adults hospitalized with hip fracture: Current nursing practices and perceived barriers. Applied Nursing Research. 2003;16:211–227

☆ 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

Article Tools

* Image Usage & Resolution