Author: Bob Kronemyer
A pain survey of 425 nurses found that for many statements, more than 50% of respondents answered incorrectly.
For instance, 49.47% of respondents answered true that “if the source of the patient’s pain is unknown, opioids should not be used during the pain evaluation period, as this could mask the ability to correctly diagnose the cause of the pain.” This statement should be answered false.
Likewise, 51.2% answered false to the question “respiratory depression rarely occurs in patients who have been receiving stable doses of opioids over a period of months.” This statement should be answered true.
Inadequate knowledge or misperceptions about pain management can lead to ineffective pain management and adverse consequences for the patient, according to nursing literature.
The pain survey used in the study was the Knowledge and Attitudes Survey Regarding Pain (KASRP), which is a reliable, valid tool cited in much of the research literature, according to Dockery. The survey consists of 38 questions: 20 true/false, 14 multiple choice and four case studies.
The investigators sent the questionnaire through the “all RN” email to 3,627 nurses at their institution. Demographic questions accompanied the survey. A total of 425 nurses participated.
Years of nursing experience also differed: zero to two years (31.82%), three to five years (16.75%), six to 10 years (11.72%) and over 10 years (39.71%).
“The study showed that there were knowledge gaps and misperceptions regarding pain and how to manage it,” Dockery said.
The study authors were not completely surprised by the results of the findings. “As many nurses are retiring, new nurses are entering the workforce, thus creating a potential knowledge gap,” Dockery said. “Being part of a research university, we recognize the importance of evaluating ongoing educational needs and providing the tools needed to meet those needs.”
The hospital’s committee plans to provide pain symposia for the nursing staff. “KASRP serves as a needs assessment tool for our upcoming pain symposium,” Dockery said. “We plan to address the potential educational barriers to pain management that were identified in the survey, and we will continue to monitor HCAHPS scores on an ongoing basis.”
“Lack of—or inadequate—pain education may pose as barriers to achieving optimal patient outcomes, and certainly places the patient at higher risk for undertreatment of pain throughout various clinical settings,” Pendergrass said. “This study highlights the need for effective pain educational initiatives and motivational strategies to be developed for nursing staff and perhaps other team members, as reflected on their previous benchmark scoring.”
Pendergrass said incorporating components of thorough pain assessment for acute and/or chronic pain, functionality tools, proper documentation, and providing up-to-date evidence-based guidelines and multimodal opioid-sparing approaches to pain management also should be considered.