Nurses' pain assessment practices with critically ill adult patients

Objectives: This study aimed to describe the perceived barriers, enablers and acute pain assessment practices of nurses caring for critically ill adult patients in a resource-limited setting. Background: Acute pain is a common problem among critically ill adult patients, and nurses' play a central role in its control. Very few studies have examined nurses' acute pain assessment practices in resource-limited settings. Methods: A descriptive and cross-sectional design was used. A total of 170 nurses working in a Ugandan hospital were enrolled. Data were collected using a questionnaire measuring various aspects of pain assessment for critically ill adult patients. Results: The majority of nurses had poor pain assessment practices. The most commonly performed pain assessment practices were documenting assessment findings, discussing pain assessment and management during nurse-to-nurse reports, and assessing for analgesics need before wound care. The main barriers to pain assessment were workload; lack of education and familiarity with assessment tools; poor documentation and communication of pain assessment priorities. The only reported enabler was physician's prescriptions for analgesia. Pain assessment practices were significantly associated with perceived workload and priority given to pain assessment. Conclusion: Pain assessment practices of nurses caring for critically ill adult patients in a resource-limited setting are affected by several barriers. Implication for nursing and health policy: Interventions to reduce barriers and enhance enablers of acute pain assessment are needed to improve pain management in critically ill adult patients. To be effective, the interventions have to be holistic and implemented by professional bodies and employers of nurses.