NWT RESEARCH DATABASE

Regions: North Slave Region

Tags: health, social sciences, education, nursing

Objective(s): To survey critical care nurses across Canada to obtain a comprehensive description of nurses’ current knowledge and practice of pain assessment and management in critically ill adults.

Project Description: The goal is to survey critical care nurses across Canada to obtain a comprehensive description of nurses’ current knowledge and practice of pain assessment and management in critically ill adults. The researchers hypothesize that considerable variation exists for pain assessment, documentation, and management as well as the education received regarding pain assessment and management priorities for the critically ill adult. The primary study objective is to identify the proportion of respondents that use a standardized pain assessment tool for critically ill patients able and unable to self-report pain and the frequency of monitoring. The tools used will also be described. The secondary objectives are to identify: (1) perceived barriers and enablers to appropriate pain practices; (2) behavioural and physiologic indicators perceived by ICU nurses as indicative of pain; and (3) the content of pain education relevant to management of the critically ill patient received by ICU nurses across Canada. This survey will be administered to a random sample of nurses identified from the 2009 database of the provincial registration bodies. Prior to survey administration a randomization list will be generated by the study statistician for each province and territory, as well as provided to the offices of the relevant registration organization to allocate survey distribution from their database. The researcher will distribute the survey and a cover letter by mail as per the procedures required for each nurse registration college/organization. Nurses will be asked to confirm they are currently practicing as a nurse in an adult intensive care unit. Those nurses practicing in ICUs that admit both adult and pediatric patients will still be eligible to complete the survey and will be advised that questions pertain specifically to the management of adult patients. Those nurses not practicing in an ICU will be asked to return the questionnaire uncompleted in the stamped, addressed envelope provided to facilitate calculation of the true survey denominator. Two weeks after survey distribution all nurses will be sent a reminder notice. Two weeks after the reminder notice all nurses who have not yet returned the survey, as identified through master logs, will be sent a replacement questionnaire. Three rounds of survey contact have been incorporated to optimize response rates. Each survey will be given a unique identifying code for the purposes of survey follow up. A master log of the unique identifiers and corresponding nurses will be maintained for the duration of the study by the administration staff of each nurse registration organization. Once the final round of questionnaire reminders has been completed, this master log will be destroyed. Descriptive statistics will be reported. To explore possible associations of response on the frequency of pain assessment using standardized tools for patients both able and unable to self-report pain the researcher will use generalized estimating equations adjusted for correlation among observations recorded from the same site. Responses will be collapsed into 2 categories (often and routinely) versus (never, seldom, frequently) and examine univariate associations between: (1) awareness of current pain assessment and management guidelines; (2) availability of pain assessment tools; (3) availability of education on pain assessment tools; (4) availability of protocols/guidelines; (5) years of critical care experience; and (6) hospital type. The fieldwork for this study will be conducted from June 25, 2010 to August 1, 2010.