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  1. Manworren, Renee C.B. PhD, APRN, AP-PMN, FAAN
  2. Atabek, Ata


OBJECTIVE: The purpose of this study was to describe factors that influence nurses' time from pain assessment to intervention for acute postsurgical pain.


BACKGROUND: Nurses' time is a limited resource that must be optimized to manage patients' pain within budget constraints. Little is known about processes and activities nurses negotiate to manage pain.


METHODS: Human factors engineering and ethnography were used to quantify factors influencing time from pain assessment to intervention.


RESULTS: On the basis of 175.5 observation hours, nurses spent 11% of shifts (mean, 83 minutes) on pain care activities. Time from alert to intervention with PRN analgesics or biobehavioral strategies for 58 cases ranged from 0 to 48 minutes (mean, <11 minutes). Five factors influenced timeliness.


CONCLUSIONS: Nurses most efficiently managed postsurgical pain by giving analgesics ordered PRN on a scheduled basis. Nurse leaders can empower prompt responses to patients' pain through delegation, process improvements, real-time monitoring, and prescriber engagement.