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Acute pain management: Implications of scientific evidence for nursing practice in the postoperative context

Authors

  • Tracey Bucknall RN, ICU Cert, BN, Grad Dip Adv Nurs, PhD, MRCNA,

    1. Associate Director, Victorian Centre for Nursing Practice Research, The University of Melbourne, Melbourne, Victoria, Australia
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  • Elizabeth Manias RN, CertCritCare, MPharm, MNStud, PhD, FRCNA,

    1. Senior Lecturer, School of Postgraduate Nursing, The University of Melbourne, Melbourne, Victoria, Australia
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  • Mari Botti RN, DipN, BA, MRCNA, PGDCAP

    1. Associate Professor, School of Nursing, Deakin University, Victoria, Australia
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Dr Tracey Bucknall, Associate Director, Victorian Centre for Nursing Practice Research, School of Postgraduate Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 1, 723 Swanston Street Carlton, Victoria, 3053, Australia. Email: t.bucknall@nursing.unimelb.edu.au

Abstract

Unrelieved acute pain remains prevalent in hospitalized patients despite advances in pain management. A decade after the Australian National Health and Medical Research Council called for improved pain management practices by health professionals, it released clinical guidelines to provide clinicians with current scientific evidence to augment their clinical decision-making. This paper examines the implications of national guidelines on nursing practice and highlights the inadequacies of current implementation policies. Pain management guidelines have failed to decrease patients' postoperative pain because organizations and researchers have ignored the impact of contextual influences on clinicians' decision-making. It is recommended that for successful implementation of national guidelines to occur at the local level of practice, organizations must assist clinicians to identify local influences on their decision-making, to address the issues specific to their own work environment and to evaluate any changes in practice.

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