International Journal of Nursing Studies
Volume 35, Issue 4 , Pages 226-232, 15 August 1998

Barriers to change: a pain management project

  • Dorothy Y. Brockopp

      Affiliations

    • College of Nursing, Office of International Affairs, University Hospital, University of Kentucky, Lexington, KY 40536-0032, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-606-257-4462; Fax: +1-606-323-2092; E-mail: dybrocko%taonode@mvs.hosp.uky.edu
  • ,
  • Gene Brockopp

      Affiliations

    • Pain Management Clinic, Department of Anesthesiology, University of Kentucky, Lexington, KY, USA
  • ,
  • Sherry Warden

      Affiliations

    • College of Nursing, Office of International Affairs, University Hospital, University of Kentucky, Lexington, KY 40536-0032, USA
  • ,
  • John Wilson

      Affiliations

    • Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
  • ,
  • Janet S. Carpenter

      Affiliations

    • Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
  • ,
  • Barbara Vandeveer

      Affiliations

    • Acute Pain Service, University of Kentucky Hospital, Lexington, KY, USA

Received 12 May 1997; received in revised form 1 February 1998; accepted 7 May 1998.

Abstract 

Although considerable effort has been directed toward improving the management of acute pain, ineffective pain management practices remain in many institutions across this country. While educational efforts have increased health care providers knowledge regarding the management of pain, a concomitant change in practice has not occurred. This project was designed to examine barriers to the effective management of pain encountered in acute care settings. A repeated case study of attempts to change was conducted in six institutions located in the southeastern United States. Results identified seven major barriers to pain management: lack of knowledge, non-facilitative attitudes, inconsistent leadership, poor working relationships, cultural and religious biases, physicians fears of legal repercussions and a lack of resources.

Keywords:  Barriers to change, Pain management, Attitudes, Knowledge, Bias, Liability, Leadership

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PII: S0020-7489(98)00035-2

International Journal of Nursing Studies
Volume 35, Issue 4 , Pages 226-232, 15 August 1998