Development and Testing of the Emergency Department Nurses’ Capacity Enhancing Program on Pain Management

Abstract

Pain has a major impact on a person’s physical, psychological, and emotional well-being. It is also a common cause of those seeking services at emergency departments. Efficient pain management is a crucial responsibility among emergency department nurses. This developmental research, based on the PRECEDE - PROCEED model of Green and Kreuter (2005), aimed to develop and test effects of the emergency department nurses’ capacity enhancing program on pain management. Research outcomes were measured by the number of clients who expressed “moderate” or higher pain relief, and the number of clients who expressed “satisfaction” or higher towards pain management.

              Participants recruited for this study were 33 emergency department registered nurses working at Maharaj Nakorn Chiang Mai Hospital, and 600 clients who sought services at the emergency department, also at Maharaj Nakorn Chiang Mai Hospital. The latter group of clients were divided equally into 2 groups of 300; the group of clients before the program implementation and the group of clients after the program implementation. Duration of study was September to December, 2013. 

              Data collection instruments were the clients’ demographic record form, the Pain Relief Questionnaire, and the Satisfaction Toward Emergency Department Pain Management Questionnaire. Study outcomes from between, before, and after the program implementation were analyzed using descriptive statistics and chi square–tests.

              The results of this study revealed that:

1. The emergency department nurses’capacity enhancing program on pain management was effective and consisted of 1) Predisposing factor management including the management of nurses’ knowledge, attitude and skill; 2)Reinforcing factors management including motivation enhancement, rewarding, providing feedback, and pain management monitoring; and 3) Enabling factor management for pain management in the emergency department, including supportive environment enhancement;
2. After program implementation, the number of clients who expressed “moderate” or higher pain relief was higher than the number before the program implementation (p < .01); and                        
3. After program implementation, the number of clients who expressed “satisfaction” towards pain management or higher was higher than of the number before the program implementation (p < .001).

              The findings of this study demonstrate that the implementation of the emergency department nurses’ capacity enhancing program on pain management, based on the PRECEDE - PROCEED model, is efficient in supporting the department’s pain management system. Therefore, it should be continuously implemented in emergency departments to ensure an efficient and sustainable pain management system.