Nurses' Knowledge and Attitudes about Pain in Hospitalized Patient

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Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Nurses' Knowledge and Attitudes about Pain in Hospitalized Patient Catherine Morrow BSN, RN Lehigh Valley Health Network Jennifer M. Lanter BSN, RN Lehigh Valley Health Network, jennifer_m.lanter@lvhn.org Kimberlee Hunsicker BSN, RN Lehigh Valley Health Network Julie Caracio BSN, RN Lehigh Valley Health Network Follow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursing Part of the Nursing Commons Published In/Presented At Morrow, C., Lanter, J., Hunsicker, K., Caracio, J. (2015, February 23). Nurses' Knowledge and Attitudes about Pain in Hospitalized Patient. Poster presented at: LVHN UHC/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA. This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org.

Nurses Knowledge & Attitudes About Pain in Hospitalized Patients Catherine Morrow, RN, BSN, MA Jennifer Lanter, RN, BSN, MGS Julie Caracio, RN, BSN Kimberlee Hunsicker, RN, BSN

Significance of the Problem Inadequacy of Treatment World Healthcare Organization [WHO], Joint Commission, Lehigh Valley Health Network Focus of Healthcare Delivery Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS], Center for Medicare & Medicaid Services [CMS]

TRIGGER Knowledge vs. Problem Knowledge Focused Triggers CMS HCAHPS

PICO QUESTION Will targeted pain management education improve nurses knowledge of pain and pain management on 4 in-patient units? P RNs on units: 4KS, 5K, OHU & TOHU I Knowledge level of RNs C Knowledge scores pre- and posteducational intervention O Enhanced nurses knowledge of pain

EVIDENCE EBSCOhost, CINAHL, Ovid Pain, Pain Management, Nurse Attitudes Peer-Reviewed, Nursing Journals, <2yrs

EVIDENCE The Joint Commission created new pain management standards in 2000, but 2011 research demonstrates that inclusion of the fifth vital sign did not improve pain management. (1) HCAHPS pain management scores support the need for education and sensitization about assessment and management of pain. (2) RNs demonstrate a lack of current education on pain management. RNs perceptions about pain and patients affects their management of pain. (1)

EVIDENCE By identifying strengths and limitations, nurses can improve their knowledge and performance. Educators in pain management should focus not only on theoretical but also on personal and ethical knowledge. (3) KASRP scores not significantly different by gender or education level, but strongly affected by exposure to previous pain education (4) A didactic education session can significantly increase scores on the KASRP (2) (5) The efficacy of an educational intervention will remain, even after months (2) (5)

Current Practice at LVHN Patient Care Manual: Definition of Pain Whatever the patient says it is, whenever s/he says it is Patient Care Manual: Key Points (excerpts) 1: knowledge of pain & pain management is associated w/ a pain experienced by patients 6: Pain is assessed & reassessed w/ interventions based on patients response & perception, and every 8 hours

IMPLEMENTATION Choose study design: quasi-experimental Gain permission for survey and tool Launch study components on TLC: 11/9 Encourage participation (use stakeholders) End data collection: 12/22 Code data and analyze using SPSS Interpret results and prepare for presentation

Practice Change The scope of this study did not include a practice change.

RESULTS Main effect for time; all scored on post- RN s at 3-5 yrs experience scored lowest No difference by education level or age No difference by self-assessed experience What do we consider to be education? Pain is what the patient says it is Only 47% - 69% correctly dosed analgesia

Implications for LVHN Educational intervention can be effective Consider mandatory education on pain for RNs and LPNs Expand in-house research on pain, pain management, and pain education

Strategic Dissemination of Results NRP Graduation Day Dr. Anna Jarrett, University of Arkansas LVHCC- 4KS, 5K, OHU, TOHU

Lessons Learned Challenges Time Coordination Resources Carolyn Davidson, Pat Karo, Michaelene Panzarella Kris Pietre Tim McCann Dr. Jason Lanter Unit Leadership and Nurses

References (1) Gropelli, T. & Sharer, J. (2013). Nurses perceptions of pain management in older adults. MEDSURG Nursing. Nov-Dec;22(6):375-82. (2) Jarrett, A., Church, T., Fancher-Gonzalez, K., Shackelford, J. & Lofton, A. (2013). Nurses knowledge and attitudes about pain in hospitalized patients. Clinical Nurse Specialist. Mar-Apr;27(2):81-7. doi: 10.1097/NUR.0b013e3182819133. (3) Blondal, K. & Halldorsdottir, S. (2009). The challenge of caring for patients in pain: from the nurse s perspective. Journal of Clinical Nursing. Oct;18(20):2897-906. doi: 10.1111/j.1365-2702.2009.02794.x. (4) Al Qadire, M. & Al Khalaileh, M. (2014). Jordanian nurses knowledge and attitude regarding pain management. Pain Management Nursing. Mar;15(1):220-8. doi: 10.1016/j.pmn.2012.08.006 (5) Gustafsson, M. & Borglin, G. (2013) Can a theory-based educational intervention change nurses knowledge and attitudes concerning cancer pain management? A quasi-experimental design. BMC Health Services Research, 13(1):328-39 (6) Ferrell, B. R. & McCaffery, M. (2012) Knowledge and Attitudes Survey Regarding Pain. City of Hope Pain & Palliative Care Resource Center. http://dx.doi.org/10.13072/midss.341

Make It Happen Questions/Comments? Contact Information: Catherine_B.Morrow@LVHN.org Jennifer_M.Lanter@LVHN.org