2.50
Hdl Handle:
http://hdl.handle.net/10755/158068
Type:
Presentation
Title:
ICU Nurses' Beliefs and Concerns Regarding Pain Management of Elders
Abstract:
ICU Nurses' Beliefs and Concerns Regarding Pain Management of Elders
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Hoeksel, Renee, PhD, RN, CCRN
P.I. Institution Name:Washington State University -Vancouver
Title:Professor
Contact Address:3300 NE 164th Street, GG #1, Ridgefield, WA, 98642-8934, USA
Contact Telephone:360-546-9621 or 360-546-9752
Co-Authors:Janet Spuck, MS, RN
Background: By the year 2020, approximately 25% of the US population is expected to be elderly (>65 years) and more ethnically diverse. Increased longevity often brings increased risk of illnesses and injuries requiring visits to the Emergency Room (ER) and subsequent hospitalization in Intensive Care Units (ICUs). Almost half of the patients in ICUs today are aged 65 years and older. Pain is one of the major stressors that patients experience in ICU settings. Pain in critically ill patients is often unnoticed, untreated, or undertreated, but the reasons are not clear. Elderly patients constitute one group that appears to be particularly vulnerable to insufficient pain management in these settings. Undertreatment of acute pain has been attributed to lack of knowledge among healthcare providers, lack of utilization of evidence-based best practices of pain management, and to nurses' and providers' beliefs and concerns about and attitudes toward pain management for older adults. Despite the increasing numbers of adults who are elderly and cared for in ICU settings, there is scant current examination of nurses' concerns and beliefs regarding pain management of critically ill elderly adults. Purpose: The purpose of this study was to explore and describe ICU nurses' beliefs, concerns and perceived barriers regarding pain management of critically ill elders. Methods: The study being reported was part of a larger study (n=75) drawn from nurses attending a local critical care conference in a large metropolitan area and intended to describe pain management knowledge of critical care nurses using quantitative instruments. Of those 75, 36 registered nurses currently working in ICU settings participated in either one of four focus groups (n=22) or 1:1 interviews (n=12). Recordings of the interactions were transcribed verbatim and analyzed using thematic analysis. Demographic variables collected included gender, age, years of nursing experience, years in critical care, highest nursing degree, shift worked, and attainment of national certification. Results: Themes uncovered revealed adherence to myths and outdated knowledge. Issues and strong concerns regarding tolerance, addiction, liver & kidney function, dementia and respiratory depression were identified. Barriers to effective pain management included how nurse educators are teaching students about pain management, "conservative" medical orders, insufficient specific guidelines especially for complex frail elders including those from ethnic minorities, patient fatigue, and under-reported alcohol abuse. Implications: Despite the JCAHO mandated emphasis on effective pain management, there appears to be a wide gap between current scientific knowledge of best practices in pain management of the elderly and its incorporation into nursing practice. A more aggressive and collaborative educational approach is needed beginning in schools of nursing and continuing into all practice settings where critically ill elders are cared for. Funded by the SW Washington Regional Research Partnership.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleICU Nurses' Beliefs and Concerns Regarding Pain Management of Eldersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158068-
dc.description.abstract<table><tr><td colspan="2" class="item-title">ICU Nurses' Beliefs and Concerns Regarding Pain Management of Elders</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hoeksel, Renee, PhD, RN, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Washington State University -Vancouver</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3300 NE 164th Street, GG #1, Ridgefield, WA, 98642-8934, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">360-546-9621 or 360-546-9752</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">hoeksel@vancouver.wsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Janet Spuck, MS, RN</td></tr><tr><td colspan="2" class="item-abstract">Background: By the year 2020, approximately 25% of the US population is expected to be elderly (&gt;65 years) and more ethnically diverse. Increased longevity often brings increased risk of illnesses and injuries requiring visits to the Emergency Room (ER) and subsequent hospitalization in Intensive Care Units (ICUs). Almost half of the patients in ICUs today are aged 65 years and older. Pain is one of the major stressors that patients experience in ICU settings. Pain in critically ill patients is often unnoticed, untreated, or undertreated, but the reasons are not clear. Elderly patients constitute one group that appears to be particularly vulnerable to insufficient pain management in these settings. Undertreatment of acute pain has been attributed to lack of knowledge among healthcare providers, lack of utilization of evidence-based best practices of pain management, and to nurses' and providers' beliefs and concerns about and attitudes toward pain management for older adults. Despite the increasing numbers of adults who are elderly and cared for in ICU settings, there is scant current examination of nurses' concerns and beliefs regarding pain management of critically ill elderly adults. Purpose: The purpose of this study was to explore and describe ICU nurses' beliefs, concerns and perceived barriers regarding pain management of critically ill elders. Methods: The study being reported was part of a larger study (n=75) drawn from nurses attending a local critical care conference in a large metropolitan area and intended to describe pain management knowledge of critical care nurses using quantitative instruments. Of those 75, 36 registered nurses currently working in ICU settings participated in either one of four focus groups (n=22) or 1:1 interviews (n=12). Recordings of the interactions were transcribed verbatim and analyzed using thematic analysis. Demographic variables collected included gender, age, years of nursing experience, years in critical care, highest nursing degree, shift worked, and attainment of national certification. Results: Themes uncovered revealed adherence to myths and outdated knowledge. Issues and strong concerns regarding tolerance, addiction, liver &amp; kidney function, dementia and respiratory depression were identified. Barriers to effective pain management included how nurse educators are teaching students about pain management, &quot;conservative&quot; medical orders, insufficient specific guidelines especially for complex frail elders including those from ethnic minorities, patient fatigue, and under-reported alcohol abuse. Implications: Despite the JCAHO mandated emphasis on effective pain management, there appears to be a wide gap between current scientific knowledge of best practices in pain management of the elderly and its incorporation into nursing practice. A more aggressive and collaborative educational approach is needed beginning in schools of nursing and continuing into all practice settings where critically ill elders are cared for. Funded by the SW Washington Regional Research Partnership.</td></tr></table>en_GB
dc.date.available2011-10-26T20:28:39Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:28:39Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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