The effect of postoperative pain management program on improving nurses' knowledge and attitudes toward pain

Effective postoperative pain treatment is an essential component to good quality of care. The purpose of this study was to explore nurses' knowledge of and attitudes toward pain in surgical wards before and after implementation of a postoperative management program at a university hospital in Jordan. The program consisted of an education program for nurses, and its effect was evaluated by using a pre- and post-intervention design. Sixty five registered nurses were asked to respond to a 21 items questionnaire, and a total of 240 patients' records were audited. After implementation of the program, the mean scores for all the questionnaire items were found to increase to 75%, with an average of 16/21 for the correct answers. There was a statistically significant difference (p < 0.05) between the number of correct answers between nurses' responses in the pre-intervention phase and their responses in the post-intervention phase for most of the questionnaire items. Also, there was a statistically significant improvement in the documentation of patients' care in 85% of the audited patients' records. It was recommended to introduce an acute pain services (APS) using a well established and safe pain management routines to increase the quality of care.     

A pain monitoring program for nurses: effects on nurses' pain knowledge and attitude

One of the reasons for inadequate pain treatment in hospitalized patients is that nurses have insufficient knowledge about pain and pain management. To address this problem, a Pain Monitoring Program (PMP) for nurses was developed, implemented, and evaluated. The PMP consisted of two components: educating nurses about pain, pain assessment, and pain management, and implementing daily pain assessment by means of a numeric rating scale. The effects of the PMP were measured in a one-group pretest–post-test design. The results show that nurses have knowledge deficits and prejudices with regard to pain and pain management. Age and additional pain courses in pain partly predict nurses' pain knowledge. After nurses were educated, the average score on the Pain Knowledge Questionnaire increased from 69.1% (SD = 13.2) at pretest to 75.8% (SD = 11.5) at post-test (P < 0.001). Nurses' attitudes changed with regard to their level of knowledge and skills in relieving pain, willingness to assess pain on a daily basis, and attention to patients' pain complaints. It can be concluded that the PMP is effective in improving nurses' knowledge of pain management and focusing nurses' attention to patients' pain complaints.     

Effects of a pain education program on nurses' pain knowledge, attitudes and pain assessment practices in China

The purpose of this study was to develop, implement, and evaluate the impact of a Pain Education Program (PEP) for nurses in China. The effects of PEP were measured in a quasi-experimental design. A total of 196 nurses who met the inclusion criteria from five nursing units in two teaching hospitals participated in the study. Randomization took place at the hospital level to select experimental and control groups. The research intervention was the PEP, which had two components: (1) to educate nurses about pain management and (2) to implement daily pain assessment by using the Changhai Pain Scale. The duration of PEP was five weeks and intervention methods included focused education, group activity, and individual instruction. After the baseline data were collected, PEP was implemented in the experimental group. The control group (n = 90) received no intervention, and the experimental group (n = 106) received six hours of focused education training. During the fourth and fifth weeks of the training program, the researcher and the faculty instructed nurses in five nursing units on how to use the Changhai Pain Scale to assess patients’ pain levels and demonstrated how to document pain condition in the nursing records. Nurses in both groups filled out a set of questionnaires, which included a background information form and the Nurses’ Knowledge and Attitude Survey form, before the PEP (T1), at one month after the PEP (T2), and at three months after the PEP (T3). Nurses in the experimental group who received the PEP had a significant improvement in their pain knowledge and attitudes. Their scores on the Nurses’ Knowledge and Attitude Survey increased from 15.67 at T1 to 26.13 at T2 and 35.14 at T3. The scores of nurses in the control group were unchanged (from 15.20 at T1 to 14.29 at T2 and 14.93 at T3, P > 0.05). In addition, experimental group nurses had an improvement in pain assessment. The percentage of nurses who correctly used the Changhai Pain Scale to assess patients’ pain intensity increased significantly after the PEP, and the increased usage of the assessment tool between experimental and control groups also shows a statistical difference in trend (χ²=93.281, P < 0.001). The PEP has been demonstrated to be effective in improving nurses’ pain knowledge, attitudes, and assessment.     

Determinants of nurses' knowledge gap on pain management in Ghana

There are concerns about adequacy of nurses' knowledge and skill in effective pain management since effective pain management promotes early recovery after surgery. This study explores factors that accounted for Ghanaian nurses' inadequate knowledge of postoperative pain management using a focused ethnographic design for data collection at a tertiary teaching hospital in Ghana. Fourteen nurses designated as key informants with different backgrounds as nurse educators and leaders were purposively sampled to participate. Data were collected through in-depth individual interviews; all interviews were conducted in English, audio-taped and transcribed verbatim. The study revealed that nurses' inadequate pain management knowledge might have resulted from curriculum gaps during training; inadequate clinical supervision, study days, and workshops for practising nurses; lack of funding for organising regular workshops; and, negative attitudes of nurses whereby new information learned at workshops was not readily applied in clinical practice. It was concluded that nursing curricula at all levels of training in Ghana should incorporate credit-bearing courses on pain management, and appropriate pain management education programmes should be instituted for practising nurses. Regular monitoring and evaluation of the impact of such education programs is required.     

新疆艾滋病高发地区护理人员艾滋病相关知识、态度调查

目的：了解新疆艾滋病重点疫送护理人员对艾滋病知识的掌握程度和对艾滋病所持有的态度,为进一步开展有针对性的培训工作提供依据。方法;采用自行设计的艾滋病知识、态度问卷以方便抽样的方法,对5个高发区的500名护理人员以匿名形式进行问卷调查。结果：护理人：员艾滋病知识总体知晓率均高于70.00％,但对不同知识回答正确率不同,对艾滋病患者／感染者持同情态度的占64．6％,不同层次的护理人员在知识、态度等方面存在差异。结论;对护理人员进行持续、全面、深入的培训是有必要的,特别要加大少数民族、低年资、低学历等护理人员的培训力度。并应既系统又有侧重点地进行。     

Developing nursing research in the United Arab Emirates: a narrative review

Aim

This article identified, critically analysed and synthesized the literature on international nursing and midwifery research capacity building and standards.

Background

The United Arab Emirates is heavily dependent up on expatriate nurses. Only 4% of nurses working within the country are Emirati. The nation is therefore committed to developing nurses and nursing as a profession.

Introduction

The United Arab Emirates’ Nursing and Midwifery Council was formed in 2009 and initially focused on regulation, education and specialization. This review was undertaken to inform the work of the Council's newly established Scientific Research Sub‐Committee.

Methods

A rapid narrative review was conducted using the Cumulative Index of Nursing and Allied Health Literature database, key words, Boolean operators, parameters and a journal‐specific search. An inclusion/exclusion criterion was identified.

Results

The search provided 332 articles with 45 included in the final review. The literature on nursing research ‘standards’ and ‘capacity building’ is diverse and inconsistent across continents and in approaches.

Discussion

Nursing research has evolved to varying degrees across the globe. Nevertheless, irrespective of the locale, there are similar problems encountered in growing research, for example nursing faculty shortage, lack of collaborative research, funding. There are also specific challenges in the Middle East and North Africa region.

Limitations

The review was constrained by time and access.

Conclusion and implications for nursing policy

There are specific challenges for the United Arab Emirates. However, the country is well placed to learn from the experiences of colleagues elsewhere. Time and commitment is required to build the solid foundations necessary to ensure robust, sustained growth. Identifying research capacity as both a process and outcome at the outset may also assist. Further, it may be prudent to consider initiating a Gulf Coast Countries’ collaborative approach to building research capacity to harness scare resources and create a larger critical mass.     

Assessment of nurses' attitudes and knowledge regarding pain management

BACKGROUND: RNs in North Carolina were surveyed to determine their current knowledge and to determine if educational preparation, practice setting, or clinical specialty influenced their knowledge levels and attitudes. METHOD: A stratified random sample of 1,000 practicing RNs in North Carolina were surveyed using the Nurses' Knowledge and Attitudes Survey Instrument developed by McCaffery and Ferrell. RESULTS: The mean score was 64.58 based on the percentage of correct responses from the 260 subjects who participated. No statistically significant difference was found in scores based on educational preparation, practice setting, or clinical specialty. CONCLUSION: The findings of this study support the concern of inadequate knowledge and inappropriate attitudes regarding pain management. It reveals the need for intensive continuing education and staff development.     

Impact of pretest on posttest knowledge scores with a Solomon Four research design

There is a paucity of research on the effects of pretest measurement with prostate cancer screening. What effect does a pretest measurement have on posttest outcomes? This research reports knowledge of prostate cancer screening among men randomized to an Enhanced decision aid versus an Usual Care decision aid. Using a Solomon Four research design, there were a total of 198 men in 4 groups. Most of the sample was African American (78%), with a mean age of 52 years. The greatest posttest knowledge occurred with the Enhanced decision aid in contrast to the Usual Care. The Enhanced/Usual Care groups that had both a pretest and posttest and had received a previous digital rectal examination had the highest means (P = .015), with means of 9.1 and 7.0, respectively. Among men who had a previous digital rectal examination, the greatest increase in score occurred among men randomized to the Enhanced decision aid in contrast to the Usual Care decision aid, 2.9 versus 0.4 (P = .008). The outcome varied based on the status of (1) random group assignment of the Solomon Four design and (2) status of previous digital rectal examination. Implications for nurses include consideration 1 of a pretest to increase posttest knowledge scores.     

Student nurses' knowledge, attitudes, and self-efficacy of children's pain management: evaluation of an education program in Taiwan

The purpose of this study was to examine the effectiveness of a pediatric pain education program (PPEP) for student nurses. The sample consisted of 181 licensed student nurses who were enrolled in a nursing school in Taiwan. Student nurses attended a 4-hour PPEP that involved case scenario discussion, video, and lecture. Data were collected by an extensive questionnaire that assessed student nurses' knowledge of, attitudes toward, and self-efficacy in pediatric pain assessment and pharmacological and nonpharmacological pain management. The results demonstrated that student nurses gained significant knowledge of pediatric pain, expressed more appropriate attitudes, and reported greater self-efficacy in children's pain management after attending PPEP. Their knowledge of analgesic pharmacotherapy did not significantly improve. These results suggest that PPEP should be integrated into pediatric nursing curricula to enhance knowledge and skills regarding children's pain management during the early stage of a nursing career.     

Emergency nurses' knowledge of perceived barriers in pain management in Taiwan

Aims and objectives. To explore knowledge of and perceived barriers to pain management among emergency nurses in Taiwan. Background. Pain is the most common patient complaint in emergency departments. Quality care of these patients depends on the pain knowledge and pain management skills of emergency nurses. However, no studies have explored emergency nurses’ knowledge of and perceived barriers to pain management in Taiwan. Design and methods. Nurse subjects (n = 249) were recruited from nine hospitals chosen by stratified sampling across Taiwan. Data were collected using the Nurses’ Knowledge and Attitudes Survey‐Taiwanese version, a scale to assess perceived barriers to pain management and a background information form. Results. The overall average correct response rate for the knowledge scale was 49·2%, with a range of 4·8–89·2% for each survey question. The top barrier to managing pain was identified by these nurses as ‘the responsibility of caring for other acutely ill patients in addition to a patient with pain. Knowledge of pain management had a significant, negative relationship with perceived barriers to pain management and a significant, positive relationship with extent of clinical care experience and total hours of prior pain management education. In addition, scores for knowledge and perceived barriers differed significantly by the nursing clinical ladder. Perceived barriers also differed significantly by hospital accreditation category. Conclusions. Our results indicate an urgent need to strengthen pain education for emergency nurses in Taiwan. Relevance to clinical practice. The pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese emergency nurses.     

急诊科护士疼痛管理知识和态度现状的调查

目的 通过对急诊护士进行疼痛管理知识和态度问卷调查,了解急诊护士疼痛管理相关知识掌握情况及实践现状,为持续改进急性疼痛护理质量、提高急诊疼痛患者管理效果提供参考.方法 应用KASRP(疼痛管理知识和态度的调查)(2008)中文版问卷对132名急诊护士进行疼痛管理知识和态度调查,采用SPSS 17.0对收集数据进行描述性分析、方差分析.结果 急诊科护士KASRP问卷答对率在25%～65%,平均答对率为(44.65±7.85)%;答对10～26条目,平均答对(17.86±3.14)条目.不同年龄、性别及工作年限答对率差异无统计学意义;不同学历及职称答对率差异有显著性.结论 急诊科护士疼痛管理知识和态度显著缺乏,疼痛基础知识点掌握不足,疼痛管理知识与临床实践之间存在偏差,有待提高和改善.     

某儿童医院护士对病人安全文化的现状评估

目的:从护士角度了解病人安全文化现状,为病人安全文化改进提供依据。方法:采用便利抽样,运用医院病人安全文化调查表对上海某儿童医院280名护士进行调查。结果:有超过半数(63.6%)的护士对所在科室患儿安全评价为"优秀"(17.1%)或"很好"(46.4%)。病人安全文化的认知同意率较高的维度依次为:科内团结合作(93.4%)、组织学习与持续改进(91.9%)、对错误的反馈与沟通(80.0%)。同意率较低的维度包括:对错误的非惩罚性反应(29.0%)、科室间协作(51.7%)、对病人安全的总体感觉(53.1%),这些为待改进的主要领域。不同科室护士对于病人安全文化的评估结果有统计学差异。结论:该院有着积极的患儿安全文化,但部分领域仍须改进。     

骨科医务人员疼痛管理知识和态度调查分析

目的探讨骨科医务人员疼痛管理知识和态度水平。方法采用骨科医务人员疼痛管理知识和态度调查表,选取58名骨科医务人员进行调查,分析疼痛管理知识和态度水平并提出相应的干预对策。结果以骨科医务人员疼痛管理知识和态度评估得分为应变量,以医务人员性别、年龄、工作年限、婚姻状况、职称、教育程度为自变量进行回归分析,结果显示年龄、工作年限、职称、教育程度均是骨科医务人员疼痛管理知识和态度影响因素(P0.05)。结论在骨科患者治疗过程中,不同层次医务人员疼痛管理知识和态度水平存在差异,医疗机构应根据医务人员的个体差异制订相应的干预对策,促进其护理知识与态度水平的提升。