Institute of Health and Wellbeing, Federation University, Australia. Electronic address: https://federation.edu.au/.
Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia. Electronic address: https://twitter.com/glamb30004.
Intensive Crit Care Nurs. 2024 Oct;84:103770. doi: 10.1016/j.iccn.2024.103770. Epub 2024 Jul 19.
Pain management of sedated and ventilated patients in intensive care units lacks consistency.
To investigate nurses' training, governance, practices, knowledge and attitudes relating to pain management in consideration of published guidelines and explore nurses' perspectives.
A survey design, using an online questionnaire with free text responses, was employed. Quantitative and qualitative data from nurses working across different hospitals were collated and saved on Qualtrics platform. Quantitative data were analysed non-parametrically and narrative responses thematically. CROSS and SRQR reporting guidelines were adhered to.
Demographics, training, governance, clinical practice, knowledge, and attitudes.
RESULTS/FINDINGS: 108 nurses participated with ninety-two completed surveys analysed. Analgesia was used to complete nursing tasks regardless of comfort needs (n = 49, 53.3 %). Changes in vital signs prompted opioid administration (n = 48, 52.1 %). Choice of analgesia depended on doctor's preference (n = 63, 68.5 %). Non-opioid therapy was administered before opioids (n = 42, 45.7 %). Sedatives were used to alleviate agitation(n = 50,54.3 %). No statistically significant difference in nurses' knowledge existed between hospitals. Weak positive relationship: r = [0.081], p = [0.441] between "knowledge scores" and "years of ICU experience" and weak negative relationship r = [-0.119], p = [0.260] between "knowledge scores" and "hours of clinical practice" was detected. Lack of training, resources, policies, high patient acuity and casual employment were acknowledged barriers to pain management. Two overarching themes emerged from narrative responses: "Pain assessment, where is it?" And "Priorities of critical illness."
The study uncovered pain management situation and examined nurses' demographics, training, governance, practices, knowledge and attitudes. Narrative responses highlighted barriers to pain management.
Health organisations should provide education, institute governance and develop policies to inform pain management. Nurses' role encompasses updating knowledge, adhering to interventions and overcoming biases. This subsequently manifests as improvement in patient outcomes.
重症监护病房镇静和通气患者的疼痛管理缺乏一致性。
调查护士在考虑发布的指南的情况下接受的培训、管理、实践、知识和态度，以了解与疼痛管理相关的内容，并探讨护士的观点。
采用调查设计，使用带有自由文本回复的在线问卷。对来自不同医院的护士收集并在 Qualtrics 平台上保存了定量和定性数据。对护士的人口统计学、培训、管理、临床实践、知识和态度进行了分析。
共有 108 名护士参与，其中 92 名完成了调查分析。无论舒适度需求如何，护士都会使用镇痛剂来完成护理任务（n=49，53.3%）。生命体征的变化促使阿片类药物的给药（n=48，52.1%）。镇痛剂的选择取决于医生的偏好（n=63，68.5%）。在使用阿片类药物之前，护士会先使用非阿片类药物（n=42，45.7%）。镇静剂用于缓解躁动（n=50，54.3%）。不同医院护士的知识得分无统计学差异。在“知识得分”和“重症监护病房工作年限”之间存在微弱的正相关关系：r=[0.081]，p=[0.441]，而在“知识得分”和“临床实践小时数”之间存在微弱的负相关关系：r=[-0.119]，p=[0.260]。缺乏培训、资源、政策、高患者发病率和临时雇佣是疼痛管理的障碍。叙事回复中出现了两个主题：“疼痛评估，在哪里？”和“危重病的优先事项。”
本研究揭示了疼痛管理的情况，并检查了护士的人口统计学、培训、管理、实践、知识和态度。叙事回复突出了疼痛管理的障碍。
卫生组织应提供教育、管理和制定政策，为疼痛管理提供信息。护士的角色包括更新知识、坚持干预措施和克服偏见。这随后表现为患者结局的改善。
