Optimizing the role of the nurse practitioner to improve pain management in long-term care

• Published in: Canadian journal of nursing research Vol. 39; no. 2; pp. 14 - 31
• Main Authors: Kaasalainen, Sharon, DiCenso, Alba, Donald, Faith C, Staples, Eric
• Format: Journal Article
• Language: English
• Published: United States Sage Publications Ltd 01.06.2007
• Subjects: Attitude of Health Personnel; Clinical Competence; Cooperative Behavior; Cross-Sectional Studies; Drug Prescriptions - nursing; Health Knowledge, Attitudes, Practice; Health Services Needs and Demand; Humans; Long term health care; Long-Term Care - organization & administration; Middle Aged; Nurse practitioners; Nurse Practitioners - education; Nurse Practitioners - organization & administration; Nurse Practitioners - psychology; Nurse's Role - psychology; Nursing; Nursing Evaluation Research; Nursing Homes - organization & administration; Nursing Methodology Research; Older people; Ontario; Pain - diagnosis; Pain - nursing; Pain management; Pain Measurement - nursing; Patient Care Team - organization & administration; Physician-Nurse Relations; Practice Guidelines as Topic; Professional Autonomy; Roles; Self Efficacy; Time and Motion Studies; Ontario; Canada
• ISSN: 0844-5621; 1705-7051

The purpose of this study was to examine the role of the nurse practitioner (NP) within an interdisciplinary model of pain management in long-term care (LTC). In a cross-sectional survey, 16 NPs in the Canadian province of Ontario (89%) indicated whether they currently performed and whether they should be performing 33 activities related to pain management and identified barriers to the fulfilment of their pain-management role. Most NPs (81.3%) reported use of pain-assessment tools, but less than half reported use of pain-management clinical practice guidelines. NPs were less involved in activities related to (a) prescribing and adjusting pain medications, (b) providing leadership in pain management, and (c) engaging in pain-related research initiatives. However, most felt that they should be more involved in these activities. Barriers to NP management of pain included time constraints; prescribing restrictions; lack of knowledge; difficulties with assessing pain; MD, staff, resident, and family reservations about use of opioids; and poor collaboration with physicians. The results indicate that NPs are not being used to their full potential in managing pain among elderly LTC residents.