Practices of Nurses in Management of Pain among Critically Ill Non-verbal adult Patients in the Critical Care Unit, Kenyatta National Hospital

Abstract

Background: Pain is a common distress among the critically ill patients, yet its assessment and management remains a major challenge to critical care givers because self-report is frequently compromised by altered level of consciousness, sedation and invasive procedures. Hence pain assessment among the critically ill nonverbal patients should remaln a top priority among nurses who are the primary group of health care professionals responsible for the ongoing monitoring of patients to ensure that pain is effectively and appropriately managed. To establish the practices of nurses in management of pain among critically ill non-verbapatients in the critical care unit. Methodology: obtain a sample size of 86 nurses working in the critical care unit, Kenyatta National Hospital. A self administered Questionnaire and an observation checklist were used to collect data. Data was entered and analyzed using SPSS version 17. Continuous data was analyzed using t-test. Categorical data was analyzed using chi- square. Measurement of association between the independent variable with key dependent variables was ascertained through logistic regression modeling. Results: and management with an overall knowl3 Likert scale was 84% indicating positive attitude. Nurses significantly considered physiological indicators more than behavioral indicators of pain in deciding to intervene. Lack opain assessment tool to guide nurses and lack of well laid out regulations for frequent pain assessments, significantly prevented nurses from rating the patient's level of pain. Results from binary logistic regression analysis indicated that the nurse's age duration worked in critical care unit and duration aftqrcritical care training were key determinants of effective pain management. Conclusion: Overall, critical care nurses need to be trained on pain assessment and management principles to improve on their knowledge for effective practice. It is also necessary to have a standard pain assessment tool for critically ill nonverbal patients with well laid out guidelines on the use of the tool. There is also need for policy change to enable critical care trained nurses prescribe analgesics based on assessment and clinical judgment without waiting for the doctor to prescribe.