Assessment of Perioperative Pain Management Practices Among Arizona Nurse Anesthetists for Open Abdominal Surgery

Abstract

With intraoperative interventions, nurse anesthetists can help improve pain control, quality of care and patient outcomes in patients undergoing open abdominal surgery. This project aimed to identify current practices, use of evidence, and barriers to implementing perioperative pain management guidelines for future practice improvement. The purpose of this project was to assess the types of evidence and barriers that guide Arizona nurse anesthetist’s decision to use evidence-based practice (EBP) for intraoperative pain management of patients undergoing open abdominal surgery. A quantitative survey consisting of Likert scale questions (n=53) assessed a convenience sample of nurse anesthesia providers (n=17) at a Level 1 hospital in Phoenix, Arizona. The results from this project concluded that guidelines from the American Society of Anesthesiologists (ASA) and American Association of Nurse Anesthetists (AANA) (n=16), were used more frequently for managing perioperative pain compared to published practice guidelines (n=9) or facility guidelines (n=9). Journal articles (n=16), Google (n=13), doctors (n=16) were reported as the most frequently used sources for evidence to guide pain management practices. The most commonly reported barriers included inadequate facility for implementation of the multimodal therapies (n=13) and lack of staff support (n=13). The framework used in this project was the Promoting Action on Research Implementation in Health Services (PARiHS) framework, which supports the translation of evidence-based research into practice. Results from this survey can be used to facilitate the process of evidence dissemination by removing barriers, resulting in the best clinical practices to improve perioperative pain management for those undergoing open abdominal surgery.