title: The nurse practitioner role in pain management in long-term care.
abstract: OBJECTIVE
  This paper is a report of a study exploring the perceptions of long-term care team members and nurse managers about barriers and facilitators to optimal use of nurse practitioners to manage residents' pain in long-term care settings.
  
  
  BACKGROUND
  Considering the high rates of pain in long-term care, research is needed to explore innovations in health-services delivery, including the emerging nurse practitioner role.
  
  
  METHODS
  For this study, an exploratory descriptive design was used to collect data in spring 2007 from five focus groups of nurses and 14 individual interviews with other healthcare team members and nurse managers. Data were analysed using thematic content analysis.
  
  
  RESULTS
  Five pain management activities performed by nurse practitioners were identified, including assessing pain, prescribing pain medications, monitoring pain levels and side effects of pain medications, consulting and advocating for staff and patients, and leading and educating staff related to pain management. Factors that influenced the implementation of the nurse practitioner role included the availability of the nurse practitioner, scope of practice, role clarity, perceived added value of nurse practitioner role, terms of employment, nurse practitioner-physician relationship. Perceived outcomes of the nurse practitioner role were also described.
  
  
  CONCLUSIONS
  The findings from this study contribute to our understanding of how the nurse practitioner role is perceived by other healthcare professionals, particularly in pain management. Stronger interprofessional collaborative relationships need to be facilitated within a model of care that includes a nurse practitioner, with the ultimate goal of improving pain management services in long-term care.
authors.affiliation: School of Nursing, McMaster University, Hamilton, Ontario, Canada. kaasal@mcmaster.ca
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: Alba
authors.initials: A
authors.lastname: Dicenso
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Pamela
authors.initials: P
authors.lastname: Baxter
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008134:Long-Term Care / Q000458:organization & administration*; D008297:Male; D009722:Nurse Practitioners / Q000523:psychology; D024802:Nurse's Role; D010146:Pain / Q000188:drug therapy*; D011795:Surveys and Questionnaires