Knowledge and self-reported practices on post-operative pain management among nurses working in surgical wards in two selected Teaching Hospitals

Abstract

A descriptive cross sectional study was conducted at Colombo South Teaching Hospital (CSTH) and Sri Jayewardenepura General Hospital (SJGH) to describe knowledge and self-reported practices on post-operative pain management (POPM). Data were collected from a convenience sample of 132 nurses working in adult surgical wards using a pre-tested self-administered questionnaire. Data were analyzed using SPSS (version-16). Mean age and years of experience of the participants were 32.5±7.7 and 7.0 ±7.9 respectively. Those who had previous education on POPM were 87.1 %. The mean score for overall knowledge was 64.9±1.4. The mean score for overall practices was 55.0±1.6. The participants had an average level of knowledge and moderate level of self-reported practices on POPM. Most participants were knowledgeable on subjectivity of pain (58.3 %), use of pain scales for pain assessment (79.5 %), and the need for administering analgesia round the clock(68.2%) while 75 % were unaware of measuring pain to assess analgesic efficacy. A majority (56.1 %) were unaware of intravenous opioids being the best method to treat sudden onset of severe pain. Administration of opioids were minimized by nurses ‘Always’ (50.8 %) and ‘Sometimes’ (42.4 %) because of the potential risk of patients becoming addicted. A total of 34.1 % nurses have given a placebo to patients to confirm the truth of their complaint on pain. Almost a half of the sample (48.5 %) has ‘Never’ used pain scales but 70 % ‘always’ have asked about the presence of pain. Degree holders (p=0.000) and those who had previous education through in-service training programs (p=0.048) had significantly high level of knowledge. Nurses who had work experience for more than 5 years (p=0.035) and previous education on pain management (p=0.018) had significantly high practice scores. Provision of nursing knowledge through specific training on POPM may contribute to improve nurses’ practices on POPM and hence to improve post-operative patient outcomes.