Nurses’ knowledge related to pain assessment for critically ill patients at a public sector hospital in Johannesburg

Abstract

Discrepancies exist between how pain is assessed in ICU patients able and unable to self report. There are pain assessment scales and guidelines that have been developed over the years for pain assessment. However, little is known regarding ICU nurses’ knowledge and current practices in the provision of pain management in the critically ill. The purpose of this study was to investigate intensive care nurses’ knowledge and practices related to pain assessment for critically ill patients. A quantitative nonexperimental, descriptive cross-sectional design was used to achieve the objectives. ICU nurse participants (n=79) were drawn from the five (5) adult ICUs in a public tertiary hospital. Data were collected using a self-administered questionnaire by Rose et al. 2011. Descriptive and inferential statistics were used to analyze the data. There was a significant difference in the nurses who used a formal pain assessment tool for patients able to self-report (mean percentage, 72.1%) compared to patients unable to selfreport (mean percentage, 52.0%) with a statistical significance (p=0.0027). However, there was no difference in the perceived importance of the use of pain scale. Nurses assessed pain frequently and were more confident in patients able to self-report than patients unable to self-report (p=0.0001). Behaviors most frequently considered indicative of pain were Restlessness (mean percentage 48.1%), and ventilator alarms (mean percentage, 47.4%). Pain assessment was considered extremely important for post-operative ICU patients and (mean percentage, 91.1%) and trauma ICU patients (mean percentage, 87.0%). Most frequently occurring barriers were unavailable pain assessment tools, lack of designated area for charting pain and hemodynamic instability. Enablers were pain prioritization in ICU and motivated staff. Most of the nurses had received pain education on various topics; however a few (29.7%) were extremely satisfied. Based on the research findings, despite participant’s perceived importance of pain assessment for patients who can self-report and those who cannot self-report, nurses were less familiar with formal pain assessment tools for patients unable to self-report and less confident in their pain assessment. Hence, a wide gap of the two groups of patients.