Pain assessment and management in intensive care unit: Nurses' practices, perceived influencing factors, and educational needs

Background: Critically ill patients and those mechanically ventilated or unable to communicate may not be able to report any pain they experience. Consequently, pain assessment and management (PAM) is challenging and underestimated in intensive care units (ICUs), where patients suffer alteration of consciousness, sedation, invasive procedures and mechanical ventilation. Aim: This study aimed to investigate ICU nurses’ PAM practices, their perceptions of influencing factors, and their related educational needs. Methods: A descriptive cross-sectional design was employed, using a valid self-reported questionnaire. Results: Among the sample of 171 nurses, 55% were male and 83% held a bachelor’s degree. 60% reported performing pain assessment for patients able to report pain and 50% for those unable to do so. Almost 40% of participants reported that pain management plans and scores were not discussed in medical rounds. Workload and lack of guidelines were reported as the most common barriers to PAM, while the most common enablers were perceived to be prescribing analgesia and considering pain a priority. Nurses recognized the need for education regarding pain, especially the physiological (50%) and psychological (47%) consequences of untreated pain. Conclusion: Nurses’ reported performance of pain assessment for ICU patients remains suboptimal. Therefore, healthcare professionals, organizations, nursing schools, and policymakers should work together to improve nurses’ PAM knowledge and practices.