Doctoral Degrees (Nursing and Midwifery)

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Browsing Doctoral Degrees (Nursing and Midwifery) by Subject "Pain -- Treatment"

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    Best practice guideline for nurses for the assessment and management of acute trauma-related pain in emergency centers
    (Stellenbosch : Stellenbosch University, 2023-03) Magerman, Yolande Nerissa; Jordan, P. J.; Van der Heever, M. M.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: Pain is a universal, common symptom experienced by patients admitted to the emergency center (EC). The global burden of pain includes trauma-related pain, which is a natural consequence of injury. Guidelines are necessary tools in evidence-based practice for the implementation of standardised nursing care with a common, efficient approach to patient care. The absence of a guideline for the assessment and management of acute trauma-related pain creates the opportunity for nurses to practice variantly and inconsistently leading to possible negative patient outcomes. Aim: The purpose of the study was to contextualise a best practice guideline for the assessment and management of acute trauma-related pain in emergency centers in the Western Cape, South Africa. Methods: The research was conducted in three phases. Phase one comprised of two quantitative studies: professional nurses in sub-study one, and the patients in sub-study two. Phase two consisted of a scoping review to identify, appraise, and summarise the content of the available best practice guidelines for the assessment and management of pain in adult patients within the emergency care settings. Phase three included the synthesis of the extracted recommendations and the drafting of the best practice guideline. Results: Data was collected from 118 professional nurses and 529 patients in the ECs of five hospitals in the Western Cape, South Africa. The findings indicated that approximately half of the nurses displayed adequate knowledge, while half have good knowledge and 4% have poor knowledge related to pain assessment and pain management. Attitudes and self-reported practices on pain assessment and management were congruent with the knowledge levels of nurses. Most of the nurses (n=63, 54%) did not consider their level of knowledge on the assessment and management of acute trauma-related pain to be up to date according to best practice nursing. Patient data findings indicated that the nurses did not consistently practise assessment and management of acute trauma-related pain in the ECs. The findings confirmed the need for base practices on the best available evidence. Six best practice guidelines on pain assessment and pain management were identified by means of the scoping review and 114 recommendations were extracted from them. The contextualised guideline was validated by nine external reviewers, who appraised the guideline using the AGREE II tool. An algorithm was developed as an evidence summary and supporting document for ease of reference for professional nurses in the EC. Conclusion: The need for a best practice guideline in the EC for professional nurses, as the end-users, was evident by the variation in practice, lack in knowledge, attitudes, and practices of nurses. A contextualised best practice guideline was developed as the end-product of this research study. Further research is recommended to implement and test the feasibility, appropriateness, meaningfulness, and effectiveness of the best practice guideline for professional nurses in the EC in a South African context.