Effect of Pain Management Educational Program on Competency of Critical Care Area Nurses: A Systematic Review

Main Article Content

Faridah Said
Zamzaliza Mulud

Abstract

Background: Pain management in critical care settings is a significant aspect of achieving quality patient care. Pain management education programs can be effective means toward enhancing the competencies of nurses in pain management. Therefore, this systematic review was conducted with the aim of examining the effects of pain management program on competency of critical care nurses.


Methodology: This systematic review was carried out according to a predefined protocols and reported according to PRISMA guidelines. The search was done on PubMed, CINAHL, EMBASE, Cochrane and PsycINFO. The quality assessment was done using the Joanna Briggs Institute’s JBI checklist for quasi-experimental studies.


Results: Overall, 14 studies met the inclusion criteria and were included in the review. All the studies were quasi- experimental and achieved high quality methodology rigor. The findings were synthesized into three major themes; effects on knowledge and attitudes, effects nurses on skills of pain management and effects on clinical practices of pain management. The educational programs improved nurses’ competencies in terms of knowledge, skills and attitudes. However, the practices of pain management were not slightly improved.


Conclusion: The educational programs proved effective in improving, knowledge, skills and attitude competencies among nurses, in relation to pain management in critical care settings. However, the integration of these competencies in real clinical practices experienced some challenges. This necessitates the need to address structural and systematic barriers that may affect application of gained competencies in clinical practice.

Article Details

Section
Articles

References

Ayenew, T., Melaku, B., Gedfew, M., Amha, H., & Bishaw, K. A. (2021). Nurses’ knowledge, practice, and associated factors of pain assessment in critically ill adult patients at public hospitals, Addis Ababa, Ethiopia. International Journal of Africa Nursing Sciences, 15, 100361. https://doi.org/10.1016/j.ijans.2021.100361

Barker, T. H., Habibi, N., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Hasanoff, S., Klugar, M., Tufanaru, C., Moola, S., & Munn, Z. (2024). The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies. JBI Evid Synth, 22(3), 378-388. https://doi.org/10.11124/jbies-23-00268

Carroll, C., & Booth, A. (2015). Quality assessment of qualitative evidence for systematic review and synthesis: is it meaningful, and if so, how should it be performed? Research synthesis methods, 6(2), 149-154. https://doi.org/10.1002/jrsm.1128

Chatchumni, M., Eriksson, H., & Mazaheri, M. (2022). Core components of an effective pain management education programme for surgical nurses: A Delphi study. Int J Qual Stud Health Well-being, 17(1), 2110672. https://doi.org/10.1080/17482631.2022.2110672

El-Aqoul, A., Obaid, A., Jarrah, I., Al-Rawashdeh, K., & Al Hroub, A. (2020). Effectiveness of education program on nursing knowledge and attitude toward pain management. Asia-Pacific Journal of Oncology Nursing, 7(4), 382-388. https://doi.org/10.4103/apjon.apjon_17_20

Gelaye, H. A., Meshesha, T. A., & Olijra, S. (2021). Knowledge, practice and factors associated with pain management for adult critical Ill patients among nurses working in federal hospitals of Addis Ababa Ethiopia 2020. American Journal of Clinical and Experimental Medicine, 9(2), 28-39. https://doi.org/10.11648/J.AJCEM.20210902.12

Germossa, G. N., Sjetne, I. S., & Hellesø, R. (2018). The impact of an in-service educational program on nurses' knowledge and attitudes regarding pain management in an Ethiopian university hospital. Frontiers in public health, 6, 229. https://doi.org/10.3389/fpubh.2018.00229

Innab, A., Alammar, K., Alqahtani, N., Aldawood, F., Kerari, A., & Alenezi, A. (2022). The impact of a 12-hour educational program on nurses’ knowledge and attitudes regarding pain management: a quasi-experimental study. BMC nursing, 21(1), 250. https://doi.org/10.1186/s12912-022-01028-4

Issa, M. R., Awajeh, A. M., Khraisat, F. S., Rasheed, A. M., Amirah, M. F., Hussain, A., & Alharthy, A. (2019). Impact of an educational program on the knowledge and attitude about pain assessment and management among critical care nurses. Dimensions of Critical Care Nursing, 38(5), 271-277. https://doi.org/10.1097/DCC.0000000000000375

Issa, M. R., Awanis Muslim, N., & Mat Sharif, Z. (2021). The Mediating Effect of Model-Based Learning on Attitude and Pain Management Awareness Among Nurses During COVID 19 Pandemic in Saudi Arabia. SAGE Open Nursing, 7, 23779608211065213. https://doi.org/10.1177/23779608211065213

Lera, M., Taxtsoglou, K., Iliadis, C., Frantzana, A., & Kourkouta, L. (2020). Nurses' Attitudes Toward Lifelong Learning via New Technologies. Asian Pac Isl Nurs J, 5(2), 89-102. https://doi.org/10.31372/20200502.1088

Ma, L.-L., Wang, Y.-Y., Yang, Z.-H., Huang, D., Weng, H., & Zeng, X.-T. (2020). Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better? Military Medical Research, 7, 1-11. https://doi.org/10.1186/s40779-020-00238-8

Mala, O., Kain, V. J., & Forster, E. M. (2024). Evaluating an educational program for enhancing neonatal intensive and special care nurses’ and midwives’ competence with neonatal pain management: A quasi-experimental study. Journal of Neonatal Nursing, 30(4), 380-387. https://doi.org/10.1016/j.jnn.2023.11.013

Miller, P. H. (2024). Moral Distress and Pain Management: Implications for Critical Care Nurses. Critical Care Nursing Clinics.

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BMC Nursing, 20(1), 62. https://doi.org/10.1186/s12912-021-00579-2

Narbona, L., Cabrera-Jaime, S., Lluch-Canut, T., Castaño, P. B., & Roldán-Merino, J. (2020). E-Learning course for nurses on pain assessment in patients unable to self-report. Nurse education in practice, 43, 102728. https://doi.org/10.1016/j.nepr.2020.102728

Nguyen, T., & Liu, H. E. (2021). Factors associated with the critical thinking ability of professional nurses: A cross-sectional study. Nurs Open, 8(4), 1970-1980. https://doi.org/10.1002/nop2.875

Nordness, M. F., Hayhurst, C. J., & Pandharipande, P. (2021). Current perspectives on the assessment and management of pain in the intensive care unit. Journal of Pain Research, 1733-1744. https://doi.org/10.2147/JPR.S256406

Olawale, M. O., Olorunfemi, O., Oyewole, O. M., & Salawu, R. A. (2020). Effect of a teaching programme on knowledge of postoperative pain management among nurses at Lagos University Teaching Hospital, Nigeria. African Journal of Health Professions Education, 12(3), 134-139. https://doi.org/10.7196/AJHPE.2020.v12i3.1343

Ozawa, M., Yokoo, K., Sumiya, T., & Kawano, R. (2022). Effectiveness of e-Learning on Neonatal Nurses' Pain Knowledge and Pain Measurement Skills: A Pilot Study. Advances in Neonatal Care, 22(2), 132-139. https://doi.org/10.1097/ANC.0000000000000894

Parvizy, S., Tarvirdinasab, S., Raznahan, R., & Aliakbari, M. (2020). The effect of pain management training in workshop on the knowledge, attitude and self-efficacy of pediatric nurses. Journal of family medicine and primary care, 9(6), 2880-2884. https://doi.org/10.4103/jfmpc.jfmpc_92_20

Rouleau, G., Gagnon, M.-P., Côté, J., Payne-Gagnon, J., Hudson, E., Dubois, C.-A., & Bouix-Picasso, J. (2019). Effects of e-learning in a continuing education context on nursing care: systematic review of systematic qualitative, quantitative, and mixed-studies reviews. Journal of medical Internet research, 21(10), e15118. https://doi.org/10.2196/15118

Salim, N. A., Joshua, R., AbuBaker, N. A., Chehab, F., & Jose, A. (2020). Effect of a nursing in-service education program on nurses’ knowledge and attitudes towards pain management in a governmental hospital in the United Arab Emirates: experimental random assignment study. Dubai Medical Journal, 2(4), 146-152. https://doi.org/10.1159/000503560

Sandvik, R. K., Olsen, B. F., Rygh, L. J., & Moi, A. L. (2020). Pain relief from nonpharmacological interventions in the intensive care unit: a scoping review. Journal of Clinical Nursing, 29(9-10), 1488-1498. https://doi.org/10.1111/jocn.15194

Sedighie, L., Bolourchifard, F., Rassouli, M., & Zayeri, F. (2020). Effect of comprehensive pain management training program on awareness and attitude of ICU nurses. Anesthesiology and pain medicine, 10(2), e98679. https://doi.org/10.5812/aapm.98679

Siddiqui, A. S., Zehra, T., Ahmed, A., Rehman, A., Ahmed, U., & Afshan, G. (2024). Enhancing Nursing Staff Clinical Skills of Pain Assessment: Impact of the Educational Course. International Journal of Nursing Education, 16(3). https://doi.org/10.37506/jdp7j820

Trouvin, A.-P., & Perrot, S. (2019). New concepts of pain. Best Practice & Research Clinical Rheumatology, 33(3), 101415. https://doi.org/10.1016/j.berh.2019.04.007

Ulrich, B., Barden, C., Cassidy, L., & Varn-Davis, N. (2019). Critical care nurse work environments 2018: findings and implications. Critical care nurse, 39(2), 67-84. https://doi.org/10.4037/ccn2019605

Uysal, N., & Yilmazer, T. (2021). The effect of pain management training on the nurses’ knowledge and practices for pain. International Journal of Caring Sciences, 14(1), 581.

Zakeri, H., Mahtosh, P., Radmehr, M., Rahbani, R., Montazeri, L., Moalemi, S., Mahdiyar, P., Hemati, F., & Karimi, A. (2024). Pain Management strategies in Intensive care unit: challenges and Best Practice. Galen Medical Journal, 13, 1. https://doi.org/10.31661%2Fgmj.v12i.3264

Zeng, X., Zhang, Y., Kwong, J. S. W., Zhang, C., Li, S., Sun, F., Niu, Y., & Du, L. (2015). The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta‐analysis, and clinical practice guideline: a systematic review. Journal of evidence-based medicine, 8(1), 2-10. https://doi.org/10.1111/jebm.12141