Browsing by Author "Denness, Kayla"

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    Factors Influencing Orthopedic Nurses' Pain Management Decision Making: A Focused Ethnography
    (2016) Denness, Kayla; Carr, Eloise; Seneviratne, Cydnee; Rae, Janice; Sawhney, Monakshi
    The experience of acute pain is highly subjective, and poor pain management contributes to a multitude of harmful conditions. Examining the context in which pain management occurs is important in formulating plans for improvement. The aim of this focused ethnography was to explore the factors orthopedic surgery nurses consider when deciding whether to initiate opioid analgesia for patients who have received a nerve block following total knee arthroplasty. Ten nurses participated in semi-structured interviews using a case study vignette. The overarching factors affecting pain management decision-making in this study relate to the culture of the unit, the self-concept of nurses, and nurses’ perception of patient assessments. Nurses are challenged to provide quality patient-centered care in a fast-paced clinical environment where efficiency and a brief length of stay are prioritized. Supporting informal nursing leaders and facilitating patient-centred care while maintaining efficiency may improve the unit culture and, in turn, pain management practices.