• Wayne Varndell, Margaret Fry, and Doug Elliott.
• Emergency Department, Prince of Wales Hospital, Randwick, NSW, Australia.
• J Clin Nurs. 2020 Jul 1; 29 (13-14): 2352-2362.

AimThe aim of this study was to examine the knowledge, perceptions and factors influencing pain assessment and management practices among Australian emergency nurses.BackgroundPain is the most commonly reported symptom in patients presenting to the emergency department, with over half rating their pain as moderate-to-severe. Patients unable to communicate, such as critically ill intubated patients, are at greater risk of inadequate pain management.DesignThis cross-sectional exploratory study used survey methodology to explore knowledge, perceptions and factors influencing pain management practices among Australian emergency nurses.MethodsAustralian emergency nurses were invited to complete an online survey comprising 91 items. The response rate was 450 of 1,488 (30.2%). STROBE guidelines were used in reporting this study.ResultsVariations in level of acute pain management knowledge, especially in older, cognitively impaired or mechanically ventilated patients were identified. Poor interprofessional communication, workload and staffing negatively impacted on nurses' intention to administer analgesia. For intubated patients, validated observation pain assessment instruments were rarely used, although respondents recognised the importance of pain management in critically ill patients.ConclusionsEmergency nurses recognise the importance of pain relief. The ability to nurse-initiate analgesia, education and training in pain management education is variable. Little education is provided on assessing and managing acute pain in elderly, cognitively impaired or mechanically ventilated patients. Use of validated pain assessment instruments to assess pain in critically ill patients is poor.Relevance To Clinical PracticeWhile pain management is the responsibility of all healthcare professionals, in the emergency department, it is a core role of emergency nursing. This study highlights the variation in ability to nurse-initiate analgesia, level of acute pain knowledge, education and training, and use of validated pain assessment instruments to guide pain management in critically ill intubated patients.© 2020 John Wiley & Sons Ltd.

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