Management of postoperative pain by nurses at the University Teaching Hospital, Kitwe Central Hospital, Levy Mwanawasa and Chipata General Hospital

Abstract

Post-operative pain management is of great importance to the patients' outcome. The better the management the more the benefit to the patient and the hospital. Benefits such as patient satisfaction, low hospital costs, reduced hospital stay and decreased complications. Effective pain management also ensures good healing process and decreases the morbidity from nosocomial infections.The main objective of this study was to explore nurses management of post-operative pain related to major surgery pain at The University Teaching Hospital, Levy Mwanawasa General, Chipata General and Kitwe Central Hospitals in Zambia.In this study, it was hypothesized that there was an association between post-operative pain management an<* nurses' knowledge and attitude.A quantitative non-interventional descriptive design was used. The study was conducted at University Teaching Hospital (UTH), Levy Mwanawasa General Hospital, Chipata General Hospital and Kitwe Central Hospital in Zambia. The study population comprised Enrolled, Registered and Bachelor of Science Nurses working in Obstetric and Surgical Wards. A non-probability purposive homogeneous sampling was used. The sample size for the whole study was 200 respondent's however, only 174 agreed to participate. For data collection, a self-administered questionnaire was used. The data was analysed electronically using SPSS Version 16.0., and to determine associations between variables Chi square test of association was performed.In this study not all the independent variables were significantly associated with post-operative pain management. It was found that there was no association between attitude and post-operative pain management (p-value 0.58). However, there was an association between knowledge and post-operative pain management (p-value 0.00). Majority 77 (88.7%) of the respondent's who showed that they had a positive attitude 92 (52.9%) did not manage post-operative pain adequately. Of those who had a negative attitude only 16 (19.5%) managed post-operative pain adequately. Therefore, having a positive or negative attitude was not a factor in managing post¬operative pain adequately.Out of a total of 174 respondent's only 44 (25.3%) representing less than quarter had high knowledge on post-operative pain management and 45 (25.9%) had medium knowledge. The Majority 85 (48.9%) accounting for almost half of the total respondent's had low knowledge. In all the knowledge levels the majority did not adequately manage post-operative pain, accounting for 29 (65.9%), 34 (75.6%), 80 (94.1%) of those with high, medium and low knowledge on post¬operative pain management respectively.In conclusion the researchers found that there is under-management of post-operative pain in health institutions, which is due to nurses not having adequate knowledge on the subject. In order to adequately manage post-operative pain nurses knowledge with regards to post-operative pain management should be improved.Based on our study findings, main recommendations made to the Ministry of Health and Ministry of Community Development Mother and Child Health, General Nursing Council of Zambia and the hospitals were to facilitate learning of the nurses' involved in caring for post¬operative patients, formulate policies which will facilitate effective and efficient delivery of post¬operative care to patients and they should also make medical and surgical supplies necessary for the management of post-operative pain readily available.