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

Journal article


Smeland, AH, Twycross, AM, Lundeberg, S and Rustøen, T (2018). Nurses' Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management. Pain Management Nursing. 19 (6), pp. 585-598. https://doi.org/10.1016/j.pmn.2018.04.006
AuthorsSmeland, AH, Twycross, AM, Lundeberg, S and Rustøen, T
Abstract

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.

Keywords1110 Nursing; 1103 Clinical Sciences; 1701 Psychology; Nursing
Year2018
JournalPain Management Nursing
Journal citation19 (6), pp. 585-598
PublisherElsevier
ISSN1532-8635
Digital Object Identifier (DOI)https://doi.org/10.1016/j.pmn.2018.04.006
Publication dates
Print16 May 2018
Publication process dates
Deposited07 Jun 2018
Accepted01 Apr 2018
Accepted author manuscript
License
File Access Level
Open
Permalink -

https://openresearch.lsbu.ac.uk/item/86qxw

Download files


Accepted author manuscript
Manuscript, resubmitting 06.02.18 AT tweaks.docx
License: CC BY-NC-ND 4.0
File access level: Open

  • 360
    total views
  • 317
    total downloads
  • 5
    views this month
  • 1
    downloads this month

Export as

Related outputs

Increasing placement opportunities at a London community trust
Twycross, A. and Adegbie, J. (2019). Increasing placement opportunities at a London community trust. Nursing Times. 115 (10), pp. 47-49.
Children’s views on postsurgical pain in recovery units in Norway: A qualitative study
Smeland, A., Rustøen, T., Næss, T., Nybro, L., Lundeberg, S., Reinertsen, H., Diseth, T.H. and Twycross, A. (2019). Children’s views on postsurgical pain in recovery units in Norway: A qualitative study. Journal of Clinical Nursing. 28 (11-12), pp. 2157-2170. https://doi.org/10.1111/jocn.14788
Reducing pain in children with cancer: Methodology for the development of a clinical practice guideline
Loeffen, EAH, Kremer, LCM, van de Wetering, MD, Mulder, RL, Font-Gonzalez, A, Dupuis, LL, Campbell, F, Tissing, WJE, Anghelescu, DL, Birnie, K, de Bont, J, Bredlau, AL, Cullen, P, Daniels, S, Dick, B, van Dijk, M, Dingeman, RS, Evan, E, Gegg, J, Gibson, F, van Grotel, M, Jibb, L, Kao, R, Knops, R, Kulkarni, K, Leroy, P, Liossi, C, Ljungman, G, McLean, J, Mensink, M, Michiels, E, Muckaden, MA, Newman, B, Positano, K, Rijsdijk, M, Rowe, E, Sangha, G, Stinson, J, Taddio, A, Taylor, H, Tutelman, P, Twycross, A, Wijnen, M and Zeltzer, L (2019). Reducing pain in children with cancer: Methodology for the development of a clinical practice guideline. Pediatric Blood and Cancer. 66 (6), p. e27698. https://doi.org/10.1002/pbc.27698
Data collection in qualitative research
Barrett, D and Twycross, AM (2018). Data collection in qualitative research. Evidence-Based Nursing. 21 (3), pp. 63-64. https://doi.org/10.1136/eb-2018-102939
Rethinking pain education
Swift, A and Twycross, AM (2018). Rethinking pain education. Evidence-Based Nursing. 21 (2), pp. 34-35. https://doi.org/10.1136/eb-2018-102886
Mothers’ Experiences of Managing their Child’s Pain Before and During Attendance at the Emergency Department
Twycross, AM and Edmonds, J (2018). Mothers’ Experiences of Managing their Child’s Pain Before and During Attendance at the Emergency Department. Journal of Clinical Nursing. 27 (9-10), pp. 2003-2013. https://doi.org/10.1111/jocn.14322
Enough is enough: time for change in pain education?
Swift, A and Twycross, AM (2018). Enough is enough: time for change in pain education? Evidence-Based Nursing. 21 (2), pp. 31-32. https://doi.org/10.1136/eb-2018-102894
Time to take a stand on nurses’ working conditions?
Twycross, AM (2018). Time to take a stand on nurses’ working conditions? Evidence-Based Nursing. https://doi.org/10.1136/eb-2018-102941
Causes of ATtrition in CHIldren's NursinG (CATCHING): An exploratory mixed method study.
McKeever, S, Whiting, L, Anderson, D and Twycross, AM (2018). Causes of ATtrition in CHIldren's NursinG (CATCHING): An exploratory mixed method study. Nurse Education in Practice. 32, pp. 44-51. https://doi.org/10.1016/j.nepr.2018.06.012
Changes to student nurse financing in the UK: A good or a bad thing?
Twycross, AM (2015). Changes to student nurse financing in the UK: A good or a bad thing? Evidence-Based Nursing. 19 (1). https://doi.org/10.1136/eb-2015-102274
Optimising palliative and end-of-life care within care home settings.
Mitchell, G and Twycross, AM (2015). Optimising palliative and end-of-life care within care home settings. Evidence-Based Nursing. 19 (4). https://doi.org/10.1136/eb-2015-102280
Causes of ATtrition in CHIldren’s NursinG (CATCHING) study
McKeever, S, Twycross, AM, Whiting, L, Anderson, D and Anderson, D (2016). Causes of ATtrition in CHIldren’s NursinG (CATCHING) study. Health Education England North Central and East London local office.
Undertaking research with children and young people
Twycross, AM and Smith, J (2017). Undertaking research with children and young people. Evidence-Based Nursing. 20 (2), pp. 40-41. https://doi.org/10.1136/eb-2017-102619
Guidelines, strategies and tools for pain assessment in children
Twycross, AM (2017). Guidelines, strategies and tools for pain assessment in children. Nursing Times. 113 (5), pp. 18-21.
Nursing and midwifery council registration for overseas children's nurses: a perfect storm?
Biggart, E and Twycross, AM (2017). Nursing and midwifery council registration for overseas children's nurses: a perfect storm? Evidence-Based Nursing. 20 (4), p. 97. https://doi.org/10.1136/eb-2017-102792
An integrative review of interventions to support parents when managing their child’s pain at home
Twycross, AM, Parker, R, McKeever, S and Wiseman, T (2017). An integrative review of interventions to support parents when managing their child’s pain at home. Pain Management Nursing. 19 (2), pp. 139-156. https://doi.org/10.1016/j.pmn.2017.10.006
For the times they are a-changing.
Twycross, AM (2017). For the times they are a-changing. Evidence-Based Nursing. 21 (1), p. 1. https://doi.org/10.1136/eb-2017-102849
What is a case study?
Heale, R and Twycross, AM (2017). What is a case study? Evidence-Based Nursing. 21 (1), pp. 7-8. https://doi.org/10.1136/eb-2017-102845
The expert patient
O'Neill, N, Mitchell, G and Twycross, AM (2016). The expert patient. Evidence-Based Nursing. 19 (2), pp. 41 - 42. https://doi.org/10.1136/eb-2016-102325
Pain as the neglected patient safety concern: Five years on.
Twycross, AM, Forgeron, P, Chorne, J, Blackman, C and Finley, GA (2016). Pain as the neglected patient safety concern: Five years on. Journal of Child Health Care. 20 (4). https://doi.org/10.1177/1367493516643422
Using observational research to obtain a picture of nursing practice
Twycross, AM and Shorten, A (2016). Using observational research to obtain a picture of nursing practice. Evidence-Based Nursing. https://doi.org/10.1136/eb-2016-102393
Parents’ experiences of managing their child’s postoperative pain at home: an exploratory qualitative study
Twycross, AM, Longard, J, Williams, A, Hong, P and Chorney, J (2016). Parents’ experiences of managing their child’s postoperative pain at home: an exploratory qualitative study. Journal of Clinical Nursing. 25 (17-18), pp. 2619-2628. https://doi.org/10.1111/jocn.13307
Perspectives on current child health issues
Twycross, AM and Smith, J (2016). Perspectives on current child health issues. Evidence-Based Nursing. 19 (4), pp. 107-109. https://doi.org/10.1136/eb-2016-102462
Have you seen the Evidence-Based Nursing blog? Evidence-Based Nursing blogs: highlighting contemporary issues in nursing.
Twycross, AM and Smith, J (2016). Have you seen the Evidence-Based Nursing blog? Evidence-Based Nursing blogs: highlighting contemporary issues in nursing. Evidence-Based Nursing. 20 (1), pp. 29-32. https://doi.org/10.1136/eb-2016-102563