Nurse Practitioners’ Persistent Pain Management Practices

There is a dearth of research on practice patterns of nurse practitioners in the

management of persistent pain in the elderly. Kaasalainen, et al., examined 18 Ontario

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nurse practitioners practice patterns and pain management approaches in older adults residing

in LTC. A cross-sectional survey resulted in sixteen (89%) of the NPs indicating 33 activities

related to pain management and identified barriers to the fulfillment of their pain-management

role in LTC. Most of the NPs (81.3%) reported utilizing pain-assessment tools with less than

half reporting the use of pain-management clinical practice guidelines. The barriers to effective

pain management by NPs included time constraints; prescribing restrictions; lack of

knowledge; difficulties with assessing pain; reservations by physicians, staff, residents, and

families toward use of opioids; and poor collaborative relationships with physicians. The

design of this study would have been better suited using a grounded theory approach to

generate a clearer understanding of the practice facilitators and barriers in prescribing opioids

by NP for older adults. These results suggest that NPs may not be utilized to their fullest

potential in managing persistent pain among older LTC residents. In addition, the results

demonstrate that NPs may not be using current pain management guidelines and thereby

inaccurately treating persistent pain in older adults.


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