Views of surgical nurses on factors influencing post-operative pain level assessment in surgical wards at the selected public hospital in Gauteng Province

Abstract

Introduction and background: The increased rate of inadequate acute post-operative pain level assessment among nurses working in surgical wards is a major concern, worldwide, including in South Africa. Literature confirms that many patients who had undergone surgery experience acute post-operative pain. Hence, pain is regarded as the fifth vital sign to be assessed post-operatively to improve patients’ care satisfaction. Despite, the assessment and management of pain post-operatively, many studies reported that patients still report insufficient pain relief post-operatively. Nurses have an important role to play by assessing, effectively communicating, managing and documenting patient’s post-operative pain levels.

Aims and objectives: The aim of the study was to explore and describe views of surgical nurses on factors influencing post-operative pain level assessment in surgical wards at the selected public hospital in Gauteng Province.

Research design: A qualitative explorative, descriptive, and contextual research design was used for this study.

Methods: The population were male and female nurses working in surgical wards at the selected public hospital in the Gauteng Province. The participants who meet the inclusion criteria were purposefully selected. Semi-structured interviews were conducted with thirteen purposefully sampled professional nurses to explore their views on factors influencing post-operative pain level assessment in surgical wards at the selected public hospital in Gauteng province. The data was collected face-to-face by the researcher using individual semi-structured interviews with the participants. The audio recorder and field notes were used through the permission of the participants. The researcher used Braun and Clarke’s (2006) approach, six phase of reflexive thematic analysis.

Findings: Three themes emerged from the study. These themes include ways of assessing post-operative pain levels, factors influencing post-operative pain level assessment and suggestions for improving post-operative pain level assessment. Themes were supported with the literature during discussion. The findings of the current study indicated that lack of standardised pain assessment tools, nurse-patient ratio, lack of in-service education, lack of commitment and lack of interprofessional communication are the most concerning factors in the surgical wards. These findings were enhanced with direct quotations from the transcriptions as verbalized by surgical wards nurses during semi-structured interviews and affected the participant’s quality nursing care in the surgical wards.

Conclusion: The findings contributed to a better understanding of the surgical nurse’s views on factors influencing post-operative pain level assessment in surgical wards. Nurses should remain clinically committed and competent with regard to post-operative pain level assessment to improve the quality of nursing care and patient’s satisfaction. The recommendations developed from the findings are relevant and can contribute to a quality nursing care in the post-operative pain level assessment of the patients in the surgical wards.