Relationship between nurses' pain knowledge and pain management outcomes for their postoperative cardiac patients

Nurses' knowledge and perceived barriers related to pain management have be en examined extensively. Nurses have evaluated their pain knowledge and man agement practices positively despite continuing evidence of inadequate pain management for patients. However, the relationship between nurses' stated knowledge and their pain management practices with their assigned surgical cardiac patients has not been reported. Therefore, nurses (n = 94) from fou r cardiovascular units in three university-affiliated hospitals were interv iewed along with 225 of their assigned patients. Data from patients, collec ted on the third day following their initial, uncomplicated coronary artery bypass graft (CABG) surgery, were aggregated and linked with their assigne d nurse to form 80 nurse-patient combinations. Nurses' knowledge scores wer e not significantly related to their patients' pain ratings or analgesia ad ministered. Critical deficits in knowledge and misbeliefs about pain manage ment were evident for all nurses. Patients reported moderate to severe pain but received only 47% of their prescribed analgesia. Patients' perceptions of their nurses as resources with their pain were not positive. Nurses' kn owledge items explained 7% of variance in analgesia administered. Hospital sites varied significantly in analgesic practices and pain education for nu rses. In summary, nurses' stated pain knowledge was not associated with the ir assigned patients' pain ratings or the amount of analgesia they received .