Ann Geriatr Med Res.  2019 Dec;23(4):190-196. 10.4235/agmr.19.0037.

Barriers and Solutions for Improving Pain Management Practices in Acute Hospital Settings: Perspectives of Healthcare Practitioners for a Pain-Free Hospital Initiative

• Akbar N
• Teo SP
• Hj-Abdul-Rahman HNA
• Hj-Husaini HA
• Venkatasalu MR

• KMID: 2470655
• DOI: http://doi.org/10.4235/agmr.19.0037

Abstract

BACKGROUND
Effective pain management is a fundamental human right. However, global disparities in pain management practices exist across health settings. This study explored healthcare practitioners' views on pain management in the acute care hospital setting.
METHODS
The focus groups included clinical specialties most likely to encounter patients with 'difficult to manage pain', namely those in the Geriatrics and Palliative Care Unit (2 doctors and 3 nurses), Critical Care Unit (7 doctors), and the Pain Management Team (3 doctors and 2 nurses). The transcripts were analyzed using a qualitative thematic analysis.
RESULTS
The data analysis revealed four themes. Theme 1, 'Being too safe' described the presence of apprehensive attitudes among patients and healthcare practitioners that limits the appropriate use of diverse and tailored pain medications in acute care hospital settings. Theme 2, 'Working as a team' described the need for collaborative approaches to achieve hospital-wide evidence-based pain management. Theme 3, 'Adaptation for local and cultural preferences' explored how pain was perceived through cultural lenses and suggested strategies to tailor pain management to local and cultural preferences. Finally, Theme 4, 'Driving acute pain management forward' listed clinician solutions for improving pain management in acute care hospital settings toward a pain-free hospital initiative.
CONCLUSION
Despite advances in pain medicine and pain teaching strategies, effective pain management is proportionate to both clinical and cultural preferences. Future studies should investigate the standardization of global pain management tools and guidelines to fit the local culture and context.

Keyword

Acute pain; Pain clinics; Pain management; Symptom assessment; Hospitals

MeSH Terms

Acute Pain
Critical Care
Delivery of Health Care*
Focus Groups
Geriatrics
Human Rights
Humans
Pain Clinics
Pain Management*
Palliative Care
Statistics as Topic
Symptom Assessment