Enhancing Nurses' Assessment of Pain Management in Dementia Patients

Enhancing Nurses' Assessment of Pain Management in Dementia Patients by Norma J. Boone MSN, Walden University, 2013 AD, Georgia Southwestern College, 1989 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2017 Abstract Chronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses’ knowledge of pain assessment and management in a 45-bed VeteransChronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses’ knowledge of pain assessment and management in a 45-bed Veterans Health Administration long-term care facility serving older adults with dementia. Knowles’ adult learning theory served as the theoretical framework and the knowledge to action model supported the translation of evidence into practice. A convenience sample of 27 licensed and unlicensed nursing staff answered the 16-question, 5-point Likert scale survey, Self-Assessment of Knowledge in Assessing Pain in Dementia Patients and 7 demographic questions. Data analysis was conducted using a one way ANOVA. Knowledge of best practices for pain assessment and management varied significantly by job title; RNs had the highest knowledge mean score (M = .74), followed by LPNs (M = .54), and then by CNAs (M = .40; p < .001). Similarly, nurses with an associate degree or higher had better knowledge (M = .74) than nurses without an associate degree (M = .42; p < .001). Knowledge was unrelated to years of employment in long-term care. However, 85% of the nurses believed pain was assessed and managed correctly in the facility. These data suggested that nurses’ assessment and management of pain may be disconnected to their self-assessment knowledge scores. Positive social change may be realized as the project findings are used to develop education for the nursing staff related to the knowledge deficits identified by the survey and application of an evidence-based tool to assess pain in cognitively-impaired older residents. Enhancing Nurses' Assessment of Pain Management in Dementia Patients by Norma J. Boone MSN, Walden University, 2013 AD, Georgia Southwestern College, 1989 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2017 Dedication This project is dedicated to my parents, the late Mr. Andrew Boone and the late Mrs. Myrtice Boone. You are the wind beneath my wings. With selflessness, you have made sacrifices of your wants and needs so that I could experience a better life. You have been the one and only constant support throughout my life. As I continue on my professional and personal journeys through life I hope that I can touch and inspire someone in the same manner in which you have inspired me. Acknowledgments I wish to thank my dear friends and co-workers, Juliet Waithe-Alexander, Dr. Hazel Jackson, Tanesha King-Roland, Dr. Charmaine Bryd, and Edwina Small for all the pep talks and endless discussions. You ladies rock! I also wish to thank Dr. Clement Wilson and Delilah White-Cummings for your mentorship and encouragement throughout this journey. Thank you, Dr. Sue Bell for the countless hours you have spent guiding me through this project. You, my dear lady, are greatly appreciated. Last but not least, thank you Collis Johnson, for the support you have shown me from the beginning to the end of this journey.