Direct Practice Improvement Project Prospectus, Research Paper Example

Do Healthcare Providers’ Knowledge and Attitude in Assessing Pain Influence Pain Management in Adult Patients with Pain in the Acute Care Setting?

Direct Practice Improvement Project Prospectus

Introduction

Pain management is a complex phenomenon that requires providers’ complete knowledge of patients who experience acute pain to ensure that their treatment is appropriate and timely in meeting their specific needs. Healthcare providers must demonstrate their ability to appropriately assess patients and treat them at the necessary level to alleviate pain. At the same time, their attitudes and perceptions of this practice must also be considered in order to provide patients with the best possible means of assessing pain that will effectively accommodate patients in the practice setting. It is necessary to identify the areas in which patients might benefit from the efforts made by nurses to improve the practice environment effectively. Direct practice improvement in this area is of critical importance in promoting a patient care setting that will promote effective patient outcomes and reflect upon the challenges of assessing pain in a manner that is consistent with the necessary objectives to improve patient health and wellbeing without placing them at further risk. This project will demonstrate a need for additional insight and guidance into the areas where care providers are able to assess pain without delays or further complications to patients with a high level of efficiency and focus on improving pain for all patients.

Background of the Problem

Nurses are responsible for providing knowledge, information, and guidance to patients regarding pain management on a continuous basis. This reflects the importance of developing new methods of evaluating pain so that patient health is not compromised, nor does it reflect any additional harm to patients who are provided with different types of treatments. It is expected that they will address questions regarding pain management and provide knowledge to patients to address the origins of pain and its impact on their health. As a result, nurses’ attitudes regarding pain management must also demonstrate their understanding of the topic and their ability to effectively demonstrate positive approaches to this process to ensure that treatments are optimized (Voshall, Dunn, & Shelestak, 2013). Currently, there appears to be significant gaps in understanding the perceptions of nurses regarding pain management and how these impact the administration of different types of treatments (Twycross, 2013). This is a critical reminder of the need to evaluate patient care needs with the best possible alternatives in mind, rather than to focus on the potential dangers of this practice and the hesitancy to administer medications for different reasons (Twycross, 2013).

Patient care outcomes must serve as the critical priority for nurses in pain assessment in management in order to promote a greater level of comfort and satisfaction in meeting patient care needs. Therefore, advocacy towards pain management must continue to improve and enable nurses to recognize the value of this practice and their behaviors and perceptions towards pain management to ensure that the needs of all patients are addressed in a positive manner (Ware, Bruckenthal, Davis, & O’Conner-Von, 2011). In this context, a practice improvement plan must evaluate the conditions under which nurse poorly perceive pain management and by which they might express discomfort or perceived lack of support for patients (Ware et.al, 2011). As a result, pain management education appears to be lacking in many areas that could ultimately provide support to nurses as they struggle through issues in this area (Tse & Ho, 2014).

Theoretical Foundations

 It is important for nurses to develop a theoretical understanding of patient care needs in the context of pain management. Quality improvement in any practice environment requires a setting that is free from distraction and outside influences that may impact nurses’ attitudes and productivity; therefore, a theoretical framework must incorporate clinical outcomes into the mix in order to promote successful recovery times (Wilson, 2014). Pain management is likely to be successful when there is an environment or culture of positive influence and support within the nursing practice setting; therefore, nurses must exercise sound and reasonable support in evaluating patients and in demonstrating their motivations towards treatment and the alleviation of pain through their core values and beliefs, without unnecessary distractions (Wilson, 2014). The primary theoretical foundations for this study include King’s Theory of Goal Attainment, Middle Range Theory emphasizing pain management, Maslow’s Hierarchy Needs, Erickson’s Theory of Personal Development, and Roy’s Adaptation Model, among others.

Review of Literature/Themes

 In the patient care environment, nurses are not always able to administer the best possible level of care and treatment to patients with pain, as this requires a high level of support and an understanding of the themes that will likely produce effective results in patients through pain management techniques. The knowledge and perceptions of nurses, even at the earliest levels of development, are challenging on many levels because there are misconceptions regarding pain management that often dictate the practice setting (Duke, Haas, Yarbrough, & Northan, 2013). In this context, nurses are not always able to set aside these perceptions in a direct care situation, thereby creating discord among nurses in regards to this practice, particularly when their competency levels are lower than required (Krokmyrdal & Andenaes, 2015). This poses a challenge to nurses and requires an understanding of their limitations and how this might influence their need for additional education in this area (Krokmyrdal & Andenaes, 2015).

Since pain management is a critical priority, it requires nurses to be proactive in their efforts to manage pain at a consistent level; however, this is not always the case when there are critical factors or perceptions that limit the use of plausible and effective pain management methods (Subramanian, Allcock, James, & Lathlean, 2012). These practices require nurses to identify their own barriers that may impact pain management and how these influence the practice environment and their administration of treatments to their patients (Czarnecki et.al, 2011). This is a critical step towards the discovery of approaches that emphasize patient care needs above personal values and beliefs regarding pain management (Czarnecki et.al, 2011). Furthermore, guidelines for pain management must be closely adhered to by nurses, while also recognizing that a significant component of practice improvement involves the development of techniques to modify existing guidelines as necessary (Habich et.al, 2012).

Problem Statement

The ability of nurses to effectively manage pain in patients is often challenging due to perceptions, attitudes, and lack of education and knowledge regarding this practice; therefore, it is important to assess the impact of personal beliefs and values in the ability of nurses to manage pain through improved education and knowledge in this area in order to prevent unnecessary risk or harm to patients with respect to this practice. Perceptions and ethical considerations are often difficult for nurses to manage in the context of pain management and may ultimately cloud their judgment and understanding of this practice (Varcoe, Pauly, Storch, Newton, & Makaroff, 2012). Since attitudes and perceptions are highly variable, this may pose a challenge in aiming to educate nurses at an effective level that will satisfy their needs accordingly (Mathew, Mathew, & Singhi, 2011). At this level, pain management must improve through a coordinated effort to address barriers and other challenges that impact the practice setting and ultimately patient care and potential outcomes (Luckett et.al, 2013).

Clinical Question(s) and Phenomenon or Clinical Questions, Hypotheses, and Variables

The primary clinical question to be considered is as follows: Do the attitudes and perceptions of healthcare providers influence the ability to acquire knowledge and to effectively manage  pain in the patient care environment? An additional clinical question is as follows: What are the barriers to acquiring knowledge and education for nurses in pain management and do these have any influence on patient outcomes? Based upon these clinical questions, it is necessary to consider the following variables: 1) Type of nursing care environment; 2) Nursing-related demographics; and 3) Type of education provided to nurses regarding pain management.

Significance of the Project

This project is significant because it demonstrates the importance of pain management in the practice setting and how it may be defined and limited by specific beliefs and perspectives that influence patient care quality. This has a significant influence on patient care resources and in the development of new methods to improve the practice setting by minimizing barriers and in supporting a practice setting where pain management is well understood by nurses.  

Rationale for Methodology

A qualitative approach to the chosen practice improvement project is essential to develop an understanding of how personal beliefs and attitudes either directly, indirectly, or have no influence on pain management in the practice environment. Therefore, the use of a survey instrument known as the “Knowledge and Attitudes Survey Regarding Pain” to evaluate attitudes and perceptions is likely to be effective in addressing the challenges of pain management for healthcare providers.

Nature of the Project Design

The project design will utilize a qualitative approach in order to evaluate the issues surrounding pain management for healthcare providers in the practice setting. A survey instrument will identify some of the attitudes and perceptions that influence patient care and require further evaluation in order to improve pain management in the practice setting. It is expected that this process will support an understanding of the use and interpretation of prior guidelines regarding pain management for patients (Rose et.al, 2012).

Purpose of the Project

The purpose of this qualitative project is to improve pain management in the practice environment by using a survey instrument in order to determine if attitudes and perceptions have an impact on acquiring knowledge and education in order to effectively manage pain in the patient care environment.

Sources of Data

This study will utilize a survey instrument in order to evaluate attitudes and beliefs regarding pain management in the practice environment in an effort to determine their impact, if any, on the quality of pain management techniques and the level of support that patients receive in regards to pain.

Data Collection Procedures

It is expected that a sample size of approximately 20-25 healthcare providers will be sufficient in order to address the research questions in greater detail and to determine how pain management is handled in the practice setting.

Data Analysis Procedures

In order to evaluate the information collected through the survey instrument, statistical analyses will be used to identify patterns in the responses that have been received. This data will enable the researcher to make determinations regarding the clinical questions that have been identified. The use of SPSS to conduct a t-test is necessary in order to evaluate the population and the differences among perspectives regarding knowledge and attitudes towards pain management.

Ethical Considerations

This study will require IRB approval and informed consent in order to protect the identity of study participants and to support confidentiality as best as possible to ensure that the data is valid and appropriate for the study’s intent and purpose.

References

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Duke, G., Haas, B. K., Yarbrough, S., & Northam, S. (2013). Pain management knowledge and attitudes of baccalaureate nursing students and faculty. Pain Management Nursing, 14(1), 11-19.

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