Perceived Barriers to Effective Pain Management among Nursing Officers Working in Intensive Care Units at National Hospital Galle, Sri Lanka

Abstract

Background: Effective pain management in Intensive Care Units (ICUs) is critical, yet nursing officers often face various perceived barriers that hinder optimal patient care. These barriers, which may include inadequate resources, insufficient training, and communication challenges, can compromise the delivery of timely and appropriate pain relief, affecting patient outcomes. Objectives: To assess the perceived barriers to effective pain management among nursing officers in the ICUs at National Hospital Galle (NHG), Sri Lanka Methods: A descriptive cross-sectional study was conducted among 164 nursing officers working at ICUs at NHG, including Emergency Trauma, Neuro Trauma, Neonatal, Pediatric, and Main Intensive Therapy Units, using convenience sampling technique. Data were collected using a researcher developed, validated, self-administered questionnaire and analysed using SPSS version 25.0, incorporating descriptive statistics and inferential statistics. The questionnaire covered demographic information, perceived barriers to ICU pain management, the availability and accessibility of related resources, and the techniques used for managing pain. Results: Most participants were female (90.9%, n=149). A significant portion had over five years of total professional experience (62.7%, n=103), and an even larger percentage had more than five years of experience working in the ICU (74.9%, n=123). Most of the participants had not participated in pain management programs (82.3%, n=135). The results showed that the most effective pain management technique was pharmacological intervention (100%). The study discovered highly influenced barriers for effective pain management in ICU at NHG are shortage of nursing staff, lack of resources, inadequate in-service program, lack of multidisciplinary approach, lack of positive attitudes, lack of education with pain assessment tools, language barriers and poor documentation of pain assessment and management (p<0.05). Conclusions: The study revealed that ICU nurses had moderate knowledge and practices regarding pain management, with gaps in the use of standardised assessment tools and attitudes toward pain. It is recommended to implement regular in-service training on pain management techniques, address staffing shortages, enhance multidisciplinary collaboration, improve resource allocation, and promote a positive attitude through continuous education to improve pain management effectiveness in ICUs. Keywords: Intensive care unit, Nursing officers, Pain management