1. Cerns, Stephanie MSN, ACNS-BC, RN-BC
  2. Mueller, Erin RN, BSN
  3. Glatzel, Cheryl BSN, MSN, CNS

Article Content


The aim of this study was to improve nursing pain management practice and patient satisfaction by addressing barriers related to basic knowledge, skills, and attitudes of staff nurses.



Despite new medication administration technology, patients continue to experience significant pain while hospitalized. Literature indicates that barriers to providing pain management by nurses may include inadequate knowledge about pain physiology, underdeveloped assessment skills, lack of knowledge related to pharmacology of analgesics, and attitudes toward pain management. Continuing education has shown to be a positive variable for improved pain management.



Currently, there has been limited formal education available for staff nurses related to pain management. Pain management practices related to pharmacologic and nonpharmacologic interventions are not universally used. In addition, patient pain satisfaction surveys indicate a need for improved pain management.



A clinical nurse specialist led a multidisciplinary team in the development of a 2-day pain management education program. This program was based on evidence-based standards, pharmacologic and nonpharmacologic interventions, and assessment skills. American Society for Pain Management Nursing and American Pain Society Guidelines and Standards were also used. Knowles Andragogy Theory and Adult Learning Principles were used as a framework for the program. Format of program consisted of lectures, case studies, and facilitated discussion. A 43-item paper/pencil questionnaire was completed before and after education. Items on the questionnaire were drawn from McCaffery and Pasero's Knowledge and Attitudes Regarding Pain tool. A total of 126 staff nurses from all areas of the hospital participated in the program.



Incorporating evidence-based interventions, national standards, and guidelines related to pain management should result in (a) increased nurses knowledge base related to pain management practice, (b) improved patient satisfaction surveys, and (c) clinicians using evidence-based interventions.



Knowledge-based questions showed a statistically significant increase between pretest and posttest scores (t = -17.29, P =.00). Nurses' attitude subscores showed a slight improvement between before and after test. Initial data analysis related to pain management indicated an increase in patient satisfaction.


Implications for Practice:

Nurses will use evidence-based practice interventions, national standards, and guidelines related to pain management. Nurses will use available resources to provide effective pain management interventions for optimal patient outcomes.


Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.


Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.


The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.