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Title: Systematic review of the predisposing, enabling, and reinforcing factors which influence nursing administration of Opioids in the postoperative period
Authors: Yin, HH
Tse, MMY 
Wong, FKY 
Keywords: Nurse's role
Opioid analgesic administration
Pain assessment
Postoperative pain management
Systematic view
Issue Date: 2015
Publisher: Wiley-Blackwell
Source: Japan journal of nursing science, 2015, v. 12, no. 4, p. 259-275 How to cite?
Journal: Japan journal of nursing science 
Abstract: Aim: To provide an overview of the administration of opioid analgesics by nurses when prescription is on an as-needed basis for postoperative pain, and to identify the important factors that determine the decisions of nurses, by using the framework of predisposing, reinforcing, and enabling causes in educational diagnosis and evaluation.
Methods: Multiple databases were searched for the period from 2000-2012. Out of a total of 1755 citations and 148 abstracts retrieved, 39 studies met the criteria for inclusion. Studies were considered eligible for review if they focused on situations or factors influencing a nurse's performance in pain assessment and the administration of opioid analgesics in postoperative pain management.
Results:The topics of the descriptive and qualitative studies presented four themes: (i) nurses' knowledge and attitudes about pain management; (ii) the situation of nurses' work practices in administrating range orders for opioid analgesics; (iii) factors that influenced nurses' work practices; and (iv) perceived barriers to effective pain management from the nurse's perspective. The experimental studies investigated the effects of different approaches in nurses' pain management practices in postoperative settings and their outcomes for patients.
Conclusion: A knowledge deficit was observed to be the reason in most cases for a nurse's failure to administrate adequate analgesics for postoperative pain relief. Pain-related education for nurses is the cornerstone to improve pain management. The integration of enabling and reinforcing factors will help nurses to develop the ability to make the decision to engage in a comprehensive intervention to improve pain management and patient outcomes.
ISSN: 1742-7932 (print)
1742-7924 (online)
DOI: 10.1111/jjns.12075
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