Emergency Nurses’ Knowledge and Attitudes Regarding PainKeri Dillon, BSN, RN, CEN; Virginia Morse, PhD, RN; Sharon Ward, MS, RN, CEN

Introduction

Purpose

National Recognized for Nursing Excellence

Every year millions of Americans develop acute pain from surgery, acute injury, or of unknown nature, while over 50 million people suffer from chronic pain conditions (Hanssen Textor & Porock, 2006). It is well known throughout the health care system that the Emergency Department (ED) is the safe haven for all patients seeking medical treatment. This study focuses on the importance of individualized and comprehensive assessment and treatment of pain in the ED among Registered Nurses (RNs). It is based on the premise that there is an abundant lack of knowledge, often due to myths and bias, regarding pain management in the health care field throughout the world.

The purpose of this study was to examine the effect of an education program on the knowledge and attitudes regarding pain management for Emergency Department Registered Nurses (EDRN) in an urban teaching facility, seeing over 42,000 patients annually. In addition, we explored the influence of EDRN culture on survey responses. The specific aims of the study were to explore the research questions:

Methods

Results

Discussion

Study Design • Quasi –experimental design, comparing a one-group pretest and post-test design Intervention• Consisted of a 60 minute voice recorded Power Point presentation on pain management, from managing acute to chronic pain in the Emergency DepartmentSample Population• Convenience sample• EDRNs at an Midwestern urban teaching hospital and Level 1 Trauma Center • 37 RNs completed the pretest and post-test survey Instrument• Nurses Knowledge and Attitudes Survey Regarding Pain (NKASRP) originally developed by Ferrell and McCaffery with established validity and reliability was modified for the Emergency Department. The tool was administered baseline and immediately post presentation and changes in the scores were analyzed

These results support previous research findings related to the problem of inadequate pain management in the hospital setting, with specific findings to the Emergency Department. Further, the findings indicate that education regarding pain management is crucial for practicing nurses. Studies with a larger number of participants should be completed in order to determine a significant correlation between experience and, or cultural background of practicing RNs. In conclusion, proper education and training of RNs throughout the health care field is essential to proper pain management practices.

Analysis

1) Will ED RN’s knowledge and attitudes about pain management change after an educational intervention focused on pain management?

2) Is there a correlation between type of nursing degree and scores (baseline and change) on the NKASRP (modified)?

3) Is there a correlation between years of experience as a RN and scores (baseline and change) on the NKASRP (modified)?

4) Is there a correlation between self reported cultural background and scores (baseline and change) on the NKASRP (modified)?

ADN

Diploma

BSN

accelerated BSN

accelerated MSN

MSN

Type of Nursing Degree

0 to 2

3 to 5

6 to 10

11 to 15

16 +

Years of Experience in NursingMean = 8 years

White

Filipino

Asian Indian

Korean

Mexican, Mexican American or Chicano

Hispanic, Latino, or Spanish origin

Race

Variable Mean (SD) Range

Pretest scores 70.59 (10.76) 40.5 to 88.1

Post-test scores 82.68 (7.68) 61.9 to 92.8

Change scores 12.1 (9.22) -7 to +35

Measures of Central Tendency and Dispersion for Pretest and Posttest Knowledge and Attitude Percentage Scores

• Results of the paired t test revealed a significant change in EDRNs knowledge and attitude scores from baseline to post intervention (t = -7.097, p = .000 )

Type of Nursing Degree

Point-biserial correlation

Years of Experience in Nursing

Spearman’s correlation

analyses

Race

Point-biserial correlation

Baseline scores r pb = .007, p = .969

rs = -.168, p =.322

r pb = .308, p = .063

Change scores r pb = .054, p = .751

rs =.029, p =.863

r pb = .069, p = .683

References: Hanssen Textor, L. & Porock, D. (2006). The Pain Management Knowledge of Nurses Practicing in a Rural Midwest Retirement Community. Journal for Nurses in Staff Development, 22(6): 307-312.

Correlation Summary