Optimizing the role of the nurse practitioner to improve pain management in long-term care.
The purpose of this study was to examine the role of the nurse practitioner (NP) within an interdisciplinary model of pain management in long-term care (LTC). In a cross-sectional survey, 16 NPs in the Canadian province of Ontario (89%) indicated whether they currently performed and whether they should be performing 33 activities related to pain management and identified barriers to the fulfilment of their pain-management role. Most NPs (81.3%) reported use of pain-assessment tools, but less than half reported use of pain-management clinical practice guidelines. NPs were less involved in activities related to (a) prescribing and adjusting pain medications, (b) providing leadership in pain management, and (c) engaging in pain-related research initiatives. However, most felt that they should be more involved in these activities. Barriers to NP management of pain included time constraints; prescribing restrictions; lack of knowledge; difficulties with assessing pain; MD, staff, resident, and family reservations about use of opioids; and poor collaboration with physicians. The results indicate that NPs are not being used to their full potential in managing pain among elderly LTC residents.
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Sharon
S
Kaasalainen
Alba
A
DiCenso
Faith C
FC
Donald
Eric
E
Staples
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000451:nursing; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D008875:Middle Aged; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration* / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology*; D015403:Nursing Evaluation Research; D009735:Nursing Homes / Q000458:organization & administration; D015404:Nursing Methodology Research; D009864:Ontario; D010146:Pain / Q000175:diagnosis / Q000451:nursing*; D010147:Pain Measurement / Q000451:nursing; D010348:Patient Care Team / Q000458:organization & administration; D019555:Physician-Nurse Relations; D017410:Practice Guidelines as Topic; D017009:Professional Autonomy; D020377:Self Efficacy; D013996:Time and Motion Studies