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.
Kaasalainen
Sharon
S
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
DiCenso
Alba
A
Donald
Faith C
FC
Staples
Eric
E
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