Nurses' competence in pain management in patients with opioid addiction: A cross-sectional survey study.

There may be up to 21 million opioid abusers in the world. Drug abuse and associated health-related problems are increasing. Opioid addiction can cause serious bacterial infection, injury and trauma, conditions that can trigger pain. Opioid abusers experience pain differently from non-addicts. There is limited research on nurses' competence to provide pain treatment to patients with opioid addiction. To report on a Norwegian pilot study examining nurses' knowledge about pain and competence in treating pain in patients who abuse opioids. A descriptive cross-sectional survey design was employed. Nurses at medical (n=64) and orthopaedic (n=34) units at two urban, public Norwegian hospitals. Data were collected in January 2010 using a self-administered questionnaire. Sample selection was determined by purposive sampling. The response rate was 54%. Eighty-eight percent of nurses did not have sufficient knowledge about pain treatment in patients with opioid addiction. Eight-eight percent and seventy-seven percent regarded work-place experience and colleagues as the primary contributors to their knowledge about pain treatment, respectively. Work-place experience contributed most to nurses' competence. Ninety percent, 70% and 84% of nurses responded that education, literature and information technology, respectively, played a minor role in obtaining knowledge about pain management. Sixty-five percent of the respondents had basic skills for evaluating pain, although 54% could not evaluate the degree of pain. Almost 62% of nurses did not trust the pain experience self-reported by patients who were opioid abusers. Our study shows shortcomings in the nurses' competence to evaluate and treat pain, suggesting that patients with opioid addiction may not receive adequate pain management. Nurses' competence to offer pain treatment to opioid abusers could be characterized as experience-based rather than evidence-based.

Krokmyrdal KA ，Andenæs R 《-》

Nurses' Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management.

Despite readily available evidence to guide practice, children continue to experience moderate to severe pain in hospital postoperatively. Reasons for this may include attitudes of nurses toward pain management and their lack of knowledge in key areas. To identify nurses' knowledge and clinical practice of pediatric postoperative pain management and whether there is a link between knowledge and practice. A descriptive cross-sectional study including a questionnaire and observations was conducted in postanesthesia care (recovery) units in six university hospitals in Norway. Nurses completed the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain Questionnaire-Norwegian Version (PNKAS-N). We observed their clinical practices using a structured observational tool and field notes. Nurses completed the PNKAS-N (n = 193) and were observed (n = 138) giving postoperative care to 266 children (70 hours per unit, 416 hours in total). The mean PNKAS-N score was 29 (standard deviation 4.2) of 40. We identified knowledge deficits, mainly in pharmacologic management, such as in risk of addiction and respiratory depression. We found that, overall, pain was assessed using validated tools in 19% of the children; this fell to 9% in children aged <5 years. More than 66% of children received an inadequate dose of morphine postoperatively. Nurses have knowledge deficits about pediatric pain management and do not always use their knowledge in practice, particularly in relation to pain assessment. There is a need to improve nurses' knowledge of pediatric pain management and to test interventions that support the use of that knowledge in practice.

Smeland AH ，Twycross A ，Lundeberg S ，Rustøen T ... -  《-》

Nurses' knowledge and skills in colonoscopy patients' pain management.

Ylinen ER ，Vehviläinen-Julkunen K ，Pietilä AM 《JOURNAL OF CLINICAL NURSING》

Postoperative pain management - the influence of surgical ward nurses.

Ene KW ，Nordberg G ，Bergh I ，Johansson FG ，Sjöström B ... -  《-》

Preventing Opioid Misuse and Potential Abuse: The Nurse's Role in Patient Education.

Nurses play a vital role in providing patient education for proper use of opioids. This descriptive study was designed to explore nurses' knowledge of opioids. Nurses in two large urban East Coast medical centers in the United States were invited to participate in the study, and 133 nurses completed the survey in its entirety. Registered nurses' knowledge of and attitudes about opioid use were assessed using a 48-item web-based questionnaire sent via e-mail. Frequencies were computed for all items on the questionnaire. Chi-squared testing was used to analyze data for all questions that fewer than 50% of participants answered correctly. The results of this study revealed a pain management knowledge gap among nurses caring for patients who are receiving opioid analgesics. This gap includes patient assessment; pharmacologic management; use of adjuvant medications; risks of addiction; risks of respiratory depression; and disposal and storage of opioid analgesics. Only 25% of the nurses answered 50% of the survey questions correctly. Demographic variables such as experience working as a nurse and length of time as a nurse did not influence how nurses performed on the questionnaire, nor did educational level. However, nurses who received education on opioids as a separate class of medication answered a higher percentage of questions correctly than those who did not receive education on opioids. The results of this study reveal a knowledge gap and nurses' lack of sufficient information about opioids that may affect their ability to provide effective medication instructions to their patients.

Costello M ，Thompson S 《-》