Implementation of a Standardized Pain Management Program Enhance Nurses’
Knowledge and Attitudes in Managing Postoperative Acute Pain in a Surgical Adult Unit

By Wong Yee Ling Elaine A, Ward 22F

Purpose

This project aimed to evaluate implementation of a Standardized Pain Management Program and the impact on nurses’ knowledge and attitudes in managing postoperative acute pain in an adult surgical unit.

Background

Pain is an individual and subjective experience. Misconceptions and concerns about the use of opioids and reluctance to report pain are barriers to effective pain management. Adequate pain management is essential for recovery. Nurses play a vital role in relieving patients’ suffering and acting as mediator between patients and health team members. Improvement of nurses’ knowledge and attitudes is the first step toward enhancement of the patient’s pain management
experience.

Methods

A standardized 4-week pain management education program consisting of four 30-minute classes was implemented. The program included current evidence regarding pain management, pain assessment and documentation skills, pharmacological & non-pharmacological interventions, and case discussions. Participants were given two references: a medication quick guide, which provides common pain relief medication indications, effect and side effects, and precautions; and a pocket-sized “Postoperative Pain Assessment and Management” guide. Promotional “CARE” pain management program information was displayed to remind staff about pain management actions and prompt them to reassess patients after interventions. Documentation was provided for staff to assess and record the pain score before and after the pain-relieving medication or intervention was provided.

Prior to implementation of the standardized pain management program, 31 staff members of an adult surgical unit were invited to complete a 33-item questionnaire addressing pain management and pharmacology during a 2-week period in April 2016. Twenty-seven of those staff completed the same survey during a 2-week period in October 2016 after attending the standardized pain management program. The pre-implementation and post-implementation
data were compared.

Results

Implementation of a standardized pain management program enhanced nurses’ knowledge and
attitudes in managing postoperative acute pain in a surgical adult unit. Mean scores improved from 52% to 81%. Incorrect answers were mainly related to pharmacology questions.

Discussion

This project demonstrated that a standardized pain management program enhances nurses’
knowledge and attitudes regarding acute postoperative pain management in an adult surgical unit. However, as the questionnaire was not in Chinese language, some questions may have be inaccurately interpreted by staff and answers may not exactly represent their actual
understanding of pain management. 

Implications/Conclusion

Implementation of a Standardized Pain Management Program enhances nurses’ knowledge
and attitudes regarding management of acute postoperative pain in an adult surgical unit. Translation of materials and assessment tools into Chinese language may help improve results and precision of findings. Additional didactic information should be focused on pharmacology. Standardized pain assessment and documentation should continue to be promoted to staff. Routine revision of pain management information should be implemented. Moreover, hospital guidelines should be revised for standard documentation to sustain project findings and implementation in/spread to other units.