In pediatric settings how can training, cultural and organizational changes affect the perceived barriers and practices of children’s pain management?
Purpose of the study
- evaluating the current pediatric pain management practices
- identifying the existing deficiencies and causes of the perceived barriers
- designing the practical solutions for the problem of undertreated children’s pain
secondary research – review of the 4 journal articles
Data collection method
Analysis of the empirical studies published in academic peer-reviewed journals
Summary of the study by Dowden et al. (2008)
The main purpose of the study by Dowden et al (2008) was exploring the main barriers to improving the existing pain management practices and offering the solution for the problem of undertreated children’s pain. Through semi-structured individual and group interviews, it has been discovered that the barriers to the global improvement include the pain culture, nurses’ attitudes and outmoded misconceptions concerning children’s pain and analgesia, inadequate nursing education and insufficient resources. Thus, along with the cultural changes, the institutional recognition of the existing problem and proper funding is essential for global improvement.
Summary of the article by MacLaren et al. (2008)
MacLaren et al. (2008) pointed out the deficiencies in the existing nursing curricula as important underlying causes of the lack of knowledge in health care professionals. The integration of 20-minutes sessions exploring the importance of children’s pain management into the educational programs had a positive impact upon the nurses’ awareness, skills and increased the likelihood of undertaking the pain management tasks.
Summary of the article by Twycross (2008)
Twycross (2008) defined the thesis that increasing the priority attributed by nurses to pain management tasks would result in improvement of pain management practices as simplistic. Through the participant observation, it has been cleared out that the lack of nurses’ awareness and improper personal attitudes towards the importance of pain management tasks are not the only underlying causes of the imperfection of the current practices. Further research is required for the effects of the nurses’ beliefs and the impact of organizational culture.
Summary of the article by Ellis et al. (2007)
Ellis et al. (2007) concluded that the organizational changes in the form of the implementation of a comprehensive program within a specific hospital setting had a positive impact upon the use of the pain scales, while the procedural tasks and their documentation remained unaffected. The integration of the best pain management techniques and the local champion component into the practices of the pediatric setting allowed improving the nursing outcomes to a certain extent.
- The barriers to effective pediatric pain management cannot be limited to nurses’ awareness
- A complex approach is required for viewing the cultural, organizational and institutional limitations for the global improvement
The adoption of a new philosophy prioritizing pain management, changes in the organizational and educational systems and institutional recognition of the problem of undertreated children’s pain are essential for the global improvement of the current pediatric pain management practices
Dowden, S., McCarthy, M. and Chalkiadis, G. (2008). Achieving organizational change in pediatric pain management. Pain Research and Management, 13(4): 321- 326.
Ellis, J., McCleary, L., Blouin, R., Rowley, B., MacNeil, M. and Cooke, C. (2007). Implementing best practice pain management in a pediatric hospital. Journal for Specialists in Pediatric Nursing, 12(4): 264- 277.
MacLaren, J., Lindsey, C., Larkin, K. and Shelton, E. (2008). Training nursing students in evidence-based techniques for cognitive-behavioral pediatric pain management. Journal of Nursing Education, 47(8): 351-358.
Twycross, A. (2008). Does the perceived importance of a pain management task affect the quality of children’s nurse’s post-operative pain management practices? Journal of Clinical Nursing, 17: 3205 – 3216.