Comprehensive and systematic assessments

Introduction

Being in pain is one main reason why an older person (those aged 65 years and over) will initially present to hospital (Goldberg & McGee 2011). Older people often have multiple pain aetiologies requiring comprehensive assessment (Herr 2011). Misconceptions about pain management in older people are based on poor knowledge, lack of understanding and myths about old age (Czarnecki et al. 2011). Evidence suggests the characteristics of the health care provider can also influence pain care provision within the acute care setting (Bartley et al. 2015). Pain is and always remains a deeply personalised and subjective experience and the multidimensional nature of pain often requires an interprofessional approach to assessment and management (International Association for the Study of Pain. 2019). The accepted gold standard for pain assessment was developed over 46 years ago by McCaffery (1968) who provided the seminal statement:

Pain is what the person says it is and exists whenever he or she says it does.

All professionals need to serve as advocates for the person in pain and ensure that pain treatment is based on ethical principles and evidence-based standards and guidelines (Herr et al. 2011) . Nurses play a critical role in effective pain management (Kerner et al. 2013) because of their frequent contact with patients in a variety of settings (Slatyer, Williams & Michael 2015).

 

Research Question:

What are the barriers and facilitators to nurses’ practice when assessing and managing pain for the older hospitalised person?

Significance:

The research question is relevant for clinical practice. Comprehensive and systematic assessments for the development of a care plan is an integral part of nursing (Nursing and Midwifery Board of Australia. 2016). Knowledge on barriers and facilitators for effective pain management will serve as a ‘road map’ that facilitates the translation of research evidence to current practice in pain care provision for older people. Appropriate knowledge translation strategies then can be selected to ensure consistent and quality pain provision to older people.