Emergency nurses perceived barriers to effective pain management at emergency department in Amhara region referral hospitals, Northwest Ethiopia, 2021. Multi-center cross sectional study

Admassie, Belete Muluadam; Lema, Girmay Fitiwi; Ferede, Yonas Admasu; Tegegne, Biresaw Ayen

doi:10.1016/j.amsu.2022.104338

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…It has been suggested that nurses' lack of knowledge and attitude toward pain management were variables influencing effective pain management. 12 Similar to a study done in Tanzania 10 patients underwent orthopedics surgery had significant association with postoperative pain. This might be due to the generally known fact that bone surgeries are associated with more severe pain and poor postoperative pain control.…”

Section: Discussionsupporting

confidence: 61%

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Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study

Admassie¹,

Admass²,

Melesse³

2023

PROM

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Background Patients undergoing surgery frequently experience unfavorable anesthetic outcomes. They may have an impact on body systems and result in more serious postoperative morbidities. This study was conducted to determine the incidence of postoperative undesirable anesthetic outcomes among surgical patients at referral hospitals in Amhara region, Ethiopia. Methods A total of 412 patients, who underwent surgical procedures between August 1 and October 30 of 2022, were included in this study. The Leiden Perioperative Care Patient Satisfaction Questionnaire’s (LPPSq) dimension “discomfort and needs” was used to collect data on the first postoperative day. Data entry and analysis were performed using SPSS version 20. To assess how risk factors affected the outcome variable, logistic regression analysis was utilized. In multivariable logistic regression analysis, a variable with a P-value of less than 0.05 was statistically considered as significant. Results The proportion of those who had “at least a little bit” of unfavorable outcomes was calculated to estimate their overall prevalence, and the prevalence of those who had “more than moderate” levels of unfavorable outcomes was determined to appreciate how severe these outcomes were. The percentages of postoperative pain, the most common undesired result, for “at least a little bit” and “more than moderate” were 87.7% and 32.3%, respectively. In this study, postoperative cold was the least prevalent (51.4%) undesirable anesthetic outcome. The remaining undesirable postoperative outcomes were reported less frequently. Conclusion and Recommendation Undesirable postoperative anesthetic outcomes were still common. The most frequent unfavorable result was postoperative pain. Adequate postoperative patient follow-up and quality service are paramount.

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Section: Discussionsupporting

confidence: 61%

“…It has been suggested that nurses’ lack of knowledge and attitude toward pain management were variables influencing effective pain management. 12 …”

Section: Discussionmentioning

confidence: 99%

Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study

Admassie¹,

Admass²,

Melesse³

2023

PROM

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“…Numerous studies have identified obstacles, such as inaccurate assessment, lack of specific tools, ineffective communication, inadequate training, absence of shared procedures, and high workloads. [12][13][14] Additional limitations may stem from "myths," such as opioid safety and the fear that analgesia may interfere with the physical examination or concerns about the risk of dependence, both from patients and healthcare providers. 15,16 Specific patient groups, such as children or the elderly, especially those with cognitive deficits or depression, are at greater risk of pain underestimation.…”

Section: Introductionmentioning

confidence: 99%

La gestione del dolore in Pronto Soccorso: una indagine fenomenologica sul vissuto degli infermieri

Lenza,

Meggiato,

Santuri

et al. 2023

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Introduzione: il dolore è un fenomeno soggettivo, individuale e complesso. È la prima causa di accesso ai Dipartimenti di Emergenza di tutto il mondo. Una precoce gestione del dolore da parte dell’infermiere tramite l’utilizzo di protocolli ha esiti positivi sulla soddisfazione dei pazienti. L’obiettivo dello questo studio è analizzare la percezione degli infermieri di Pronto Soccorso circa il dolore dei pazienti adulti afferenti al servizio, evidenziando le barriere principali all’obiettività della valutazione e le modalità utilizzate per gestirlo, al fine di migliorare il corretto management del dolore. Materiali e Metodi: il disegno di studio è di tipo qualitativo con analisi fenomenologica interpretativa attraverso la conduzione di interviste libere e narrative, strutturato secondo le indicazioni della checklist COREQ-32. Risultati: sono stati intervistati 20 infermieri di Pronto Soccorso appartenenti a due aziende sanitarie della regione Veneto. Dalle interviste sono emersi sette temi principali: protocolli per la somministrazione di terapia, gestione del dolore nel bambino, procedure non farmacologiche, differenze tra pazienti con dolore acuto e cronico, caregiver e pazienti anziani o con deficit cognitivo, esperienze personali di dolore del personale sanitario, obiettività della valutazione infermieristica. Conclusioni: dall’analisi delle interviste sono emersi fattori ostacolanti una ottimale gestione del dolore legati al contesto, come il sovraffollamento dei Pronto Soccorso, o a particolari categorie di pazienti di difficile gestione, come bambini o anziani con deficit cognitivi. Sono inoltre emerse esperienze positive, come l’utilità delle tecniche non farmacologiche e il ruolo partecipativo di familiari e caregiver, in particolare nella valutazione del dolore.

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Why is pain management so difficult in the Emergency Department? A systematic mixed studies review and thematic synthesis of staff perceptions of enablers and barriers to pain management within the Emergency Department

Sampson

Johnson

2023

Emerg Med J

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IntroductionPain is the most common presenting feature within the ED, yet undertreatment of pain in the ED is a well-documented problem worldwide. Despite the development of interventions to address this problem, there is still limited understanding of how pain management can be improved within the ED. This systematic mixed studies review aims to identify and critically synthesise research exploring staff views of barriers and enablers to pain management to understand why pain continues to be undertreated in the ED.MethodsWe systematically searched five databases for qualitative, quantitative and mixed methods studies reporting ED staff views of barriers and enablers to pain management in the ED. Studies were quality assessed using the Mixed Methods Appraisal Tool. Data were extracted and qualitative themes were generated by deconstructing data then developing interpretative themes. Data were analysed using convergent qualitative synthesis design.ResultsWe identified 15 297 articles for title/abstract review, reviewed 138 and included 24 in the results. Studies were not excluded due to low quality, although lower scoring studies contributed less data to the analysis. Quantitative surveys focused more on environmental factors (eg, high workload and bureaucratic restrictions), while qualitative studies revealed more insight about attitudes. We developed five interpretative themes from the thematic synthesis: (1) pain management is seen as important but not a clinical priority; (2) staff do not recognise the need to improve pain management; (3) the ED environment makes it difficult to improve pain management; (4) pain management is based on experience, not knowledge; and (5) staff lack trust in the patient’s ability to judge pain or manage it appropriately.ConclusionsOverly focusing on environmental barriers as principal barriers to pain management may mask underlying beliefs that hinder improvements. Improving feedback on performance and addressing these beliefs may enable staff to understand how to prioritise pain management.

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Emergency nurses perceived barriers to effective pain management at emergency department in Amhara region referral hospitals, Northwest Ethiopia, 2021. Multi-center cross sectional study

Cited by 5 publications

References 36 publications

Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study

Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study

La gestione del dolore in Pronto Soccorso: una indagine fenomenologica sul vissuto degli infermieri

Why is pain management so difficult in the Emergency Department? A systematic mixed studies review and thematic synthesis of staff perceptions of enablers and barriers to pain management within the Emergency Department

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