Exploring the educational needs of nurses on children's pain management: A descriptive qualitative study.

To explore the educational needs of nurses on children's pain management. A descriptive qualitative study. Individual and group interviews were conducted among 28 nurses and four nurse managers at four hospitals in the Ashanti region of Ghana. The recorded interviews were later transcribed verbatim and thematically analysed based on a conceptual interest in the educational needs on paediatric pain management. Nurses were acquainted with pain assessment of children who can verbally communicate. They mainly used drugs in treating pain and were familiar with the use of some non-pharmacological interventions. Notwithstanding, they desired to know more about pain assessment for children with non-functional speech. Additionally, they were interested in learning more about both drug and nondrug pain relief methods for children. The sampled nurses and nurse managers indicated diverse preferences on the nature of the paediatric pain educational programme based on their personal choices and working dynamics.

Kusi Amponsah A ，Kyei-Dompim J ，Bam V ，Kyei EF ，Oduro E ，Ahoto CK ，Axelin A ... -  《Nursing Open》

Nursing-Related Barriers to Children's Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study.

Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children's pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children's pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children's pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n = 24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses' inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children's pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children's pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management.

Kusi Amponsah A ，Kyei EF ，Agyemang JB ，Boakye H ，Kyei-Dompim J ，Ahoto CK ，Oduro E ... -  《-》

The experiences of acute non-surgical pain of children who present to a healthcare facility for treatment: a systematic review protocol.

Pope N ，Tallon M ，McConigley R ，Wilson S ... -  《-》

From registered nurse to nursing student - Exploring registered nurses' transition to nursing student during a post-registration children's nurse programme: A qualitative descriptive research study.

Registration as a children's nurse in Ireland occurs via two routes, an undergraduate degree in children's and general nursing and a twelve-month post-registration children's nurse programme. Candidates undertaking the latter are experienced nurses on the register for either general, intellectual disability or mental health nursing yet they are required to become a nursing student for the duration of the programme. Although anecdotal evidence indicates that this presents unique challenges for these students the experiences of transitioning from registered nurse to nursing student has not been explored since inception of the programme in 2006. The study aimed to explore the experiences of the registered nurse that transitioned to nursing student during the Post-registration Children's Nurse Programme, to identify the previous experience of the registered nurse and to identify what challenged and supported successful transition. A qualitative descriptive research design was used. The study was carried out in a large teaching children's hospital in Dublin, Ireland. A purposeful sample of six registered nurses that completed the programme within the last 12 months was interviewed about their experiences of being a post-registration nursing student. Face-to-face, semi-structured, conversation-style interviews were conducted. Four main themes were identified from the data: 'Feelings related to returning to student status', 'Supports throughout the transition', 'Differences between disciplines' and 'Knowing your place'. Registered General Nurses (RGN) had different learning needs in comparison to registered nurses in intellectual disability (RNID) and expressed difficulty adapting to the role of nursing student as they felt that their previous knowledge and experience was being overlooked. In contrast, RNIDs were more challenged on clinical placement by unfamiliarity with clinical equipment and terminology. Both RNIDs and RGNs found that the nursing staff on their placements were a source of support despite reporting that they rarely worked with their designated preceptor. The challenges experienced by nursing students from different nursing disciplines sharing the same post-registration programme needs to be considered in the planning and implementation of all aspects of the programme. Healthcare staff should become more aware of the challenges experienced by the postgraduate nursing student when educating and supporting their learning within the preceptor-student relationship.

Nyhan T ，Howlin F 《-》

Paediatric nurses' postoperative pain management practices in hospital based non-critical care settings: a narrative review.

To investigate paediatric nurses' postoperative pain management practices with the aim of identifying the factors associated with undermanaged paediatric postoperative pain. Systematic search and review. PsychInfo, CINAHL, PubMed, EMBASE and hand searching. English peer-reviewed quantitative, qualitative, or mixed methods research articles published between 1990 and 2012 exploring registered nurses' paediatric postoperative pain management practices were included. Articles with a primary focus on nurses' pain management practices in the neonatal or paediatric intensive care units, recovery room, and/or focused on children with cognitive impairment were excluded. The search terms used were: postoperative pain; nurs*; paediatrics; pediatrics; children; pain assessment; non-pharm*; analges*. Titles and abstracts were used for initial screening. Two researchers conducted data extraction and assessment of rigour for each paper. From the initial 248 citations, 27 studies were included. Most studies were descriptive and examined relationships between personal factors and nurses' pain management practices. Observational data from four papers added insights beyond that provided in self-report studies. Two articles used experimental designs with vignettes. Data were categorised into four topics: pain assessment; pharmacological practices; non-pharmacological practices; and factors affecting practices. Despite improvements in analgesic administration over the past 20 years, practices remain suboptimal. Children's behaviour appears to influence nurses' pain assessment more than validated measures. A significant proportion of children did not have pain scores recorded in the first 24-h postoperatively. Children receive more analgesia when ordered around the clock compared to as required. However, around the clock analgesia prescription did not guarantee administration. Nurses reported using several non-pharmacological strategies routinely but some are not evidence based. The results of this review indicate nurses' assessment and management of children's pain is not consistent with published guidelines. Results of studies exploring nurse and child related factors are inconclusive. Research needs to examine the impact of organisational factors on nurses' pain care practices. Intervention studies are needed to determine the most effective strategies to support and improve nurses' pain care for children.

Twycross A ，Forgeron P ，Williams A 《-》