Pretorius Annatjie, Searle Judy, Marshall Bob
Emergency Department, Hawke's Bay District Health Board, Hastings, New Zealand.
School of Nursing, Eastern Institute of Technology, Napier, New Zealand.
Pain Manag Nurs. 2015 Jun;16(3):372-9. doi: 10.1016/j.pmn.2014.08.015. Epub 2014 Oct 31.
Pain is the most common reason for presentation to the emergency department (ED). On presentation patients expect rapid pain relief, yet this is often not met. Despite extensive improvements in analgesia medication there are still barriers to nurses' assessment, management, documentation, and reassessment of pain. The aim of this study is to identify barriers, enablers, and current nursing knowledge regarding pain management. Using an anonymous quantitative web-based survey, members of the College of Emergency Nurses New Zealand were invited to complete a questionnaire on pain assessment and management. The questionnaires were analyzed using descriptive statistics. Enablers to ED nurses' improved management of pain were the provision of nurse-initiated analgesic protocols and pain management champions. Common barriers perceived by the respondents were the responsibility of caring for acutely ill patients as well as a patient with pain. Similar barriers to previous research were identified and included lack of time, workload, reluctance of clinicians to prescribe analgesia, and the lack of nursing knowledge regarding opioid administration. Raising awareness that oligoanalgesia exists in the ED is essential. This research suggested that nurses would benefit from ongoing education on the usage of opioids. Nurses' attitude regarding patients' right to expect total pain relief as a consequence of treatment was also an issue. ED nurses, by virtue of their role, are in a unique position to be leaders in pain assessment and pain management.
疼痛是患者前往急诊科就诊的最常见原因。就诊时，患者期望疼痛能迅速缓解，但这一期望往往无法实现。尽管镇痛药物有了广泛改进，但护士在疼痛评估、管理、记录及重新评估方面仍存在障碍。本研究的目的是确定疼痛管理方面的障碍、促进因素以及当前的护理知识。通过一项基于网络的匿名定量调查，邀请新西兰急诊护士学院的成员填写一份关于疼痛评估与管理的问卷。问卷采用描述性统计方法进行分析。促进急诊科护士改善疼痛管理的因素包括提供由护士发起的镇痛方案以及疼痛管理倡导者。受访者认为常见的障碍是既要照顾急症患者又要照顾疼痛患者。研究发现了与以往研究类似的障碍，包括时间不足、工作量大、临床医生不愿开具镇痛药以及护士缺乏阿片类药物给药知识。提高对急诊科存在镇痛不足现象的认识至关重要。这项研究表明，护士将从持续的阿片类药物使用教育中受益。护士对于患者因治疗而期望完全缓解疼痛这一权利的态度也是一个问题。急诊科护士因其角色的特殊性，处于疼痛评估和疼痛管理领导者的独特地位。
