Optimizing the role of the nurse practitioner to improve pain management in long-term care

Can J Nurs Res. 2007 Jun;39(2):14-31.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Clinical Competence
  • Cooperative Behavior
  • Cross-Sectional Studies
  • Drug Prescriptions / nursing
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Long-Term Care / organization & administration
  • Middle Aged
  • Nurse Practitioners / education
  • Nurse Practitioners / organization & administration*
  • Nurse Practitioners / psychology*
  • Nurse's Role / psychology*
  • Nursing Evaluation Research
  • Nursing Homes* / organization & administration
  • Nursing Methodology Research
  • Ontario
  • Pain / diagnosis
  • Pain / nursing*
  • Pain Measurement / nursing
  • Patient Care Team / organization & administration
  • Physician-Nurse Relations
  • Practice Guidelines as Topic
  • Professional Autonomy
  • Self Efficacy
  • Time and Motion Studies