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Verbal presentation 05.09.2014


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Verbal presentation 05.09.2014

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Verbal presentation 05.09.2014

  1. 1. What factors influence nurses adherence to paediatric pain management guidelines in New Zealand hospitals? An exploratory study of nurses experiences. METHODS OF RESEARCH AND ENQUIRY 556301 RDP GROUP PRESENTATION NURSING 64-1 R AQUE L MUR PHY ( 1 3 0 2 6 5 5 ) , K E E LY Mc COWAT T ( 1 3 9 3 2 1 2 ) , MADDI POL E ( 1 3 8 6 9 5 5 ) , SA RAH ROB INSON ( 1 3 9 6 4 8 6 ) , E V E LYN WA RDEN ( 1 1 1 9 2 3 5 ) 5 September 2014
  2. 2. Research issue and rationale for research question •The prevalence of pain in the hospitalised paediatric population is high, and the pain intensity is often rated moderate to severe (Kozlowski et al., 2014). •Nurses rely on techniques such as subjective observations of body language and other non-verbal cues to manage pain (Twycross and Collins, 2011). •Habich et al. (2012) and Twycross and Collins (2011) found that there is insufficient adherence to hospital-developed pain management guidelines. •Use of guidelines can assist nurses to deliver effective pain management (Bernhofer, 2011). 2
  3. 3. What factors influence nurses adherence to paediatric pain management guidelines in New Zealand hospitals? An exploratory study of nurses experiences. Aims: •To identify factors that have an influence on nurses adherence to paediatric pain management guidelines. ◦ ‘Factors’ could either encourage or discourage adherence to guidelines. ◦ ‘Willingness’ and ‘ability’ to adhere to guidelines will be explored. •To develop new insight into this important issue which has not been explored in earlier research. •To help inform improvements to paediatric pain management practice. 3
  4. 4. Research approach and rationale for approach •Qualitative research approach: An exploratory design. • Generates new insight for a problem that has not clearly been defined (Werner, 2007). •Hermeneutic phenomenology design • Provides insight into the experience of others • Becomes Hermeneutic when method becomes interpretative (rather than purely descriptive) (Kafle, 2011). •Key characteristics • Semi-structured focus groups with open-ended questions • Participants to be given transcripts from focus group to allow for amendment. •Why is this an appropriate choice? 4
  5. 5. Ethical considerations •AUT Ethics Committee • Requirements, guidelines and procedures •ADHB approval process for Low Risk study: • Submitting application form for research approval to the ADHB • Obtaining approval at the department/service level • Register the project at the research office •How is this research project ethical? • The aim of improving paediatric pain management practice • Integration of Te Tiriti o Waitangi principles 5
  6. 6. Study participants •A combination of registered nurses, enrolled nurses, and nurse practitioners •Currently working in paediatric ward at Auckland DHB • At least 30 hours per week •With at least one years experience in paediatrics •Recruitment •Sample Size •Ethical Consideration •Cultural Considerations 6
  7. 7. Research design •Data collection technique: • Focus group sessions of 5-6 nurses. •What: • 5-10 one hour sessions. • Dependant on response to recruitment efforts. •How: • Guided questions  open conversation among the participants. • Sessions will be recorded and transcribed. • Privacy and confidentiality in storage of data. •When: • AM / PM shift overlap. • 6 months. 7
  8. 8. Data analysis Process: 1. Researchers will read the focus group transcripts and become familiar with the ‘essence’ of the nurses experiences. 2. Researchers will allow participants to review their transcripts with the opportunity to make amendments. 3. After integrating participant feedback, researchers will codify the transcripts, organising text into individually identifiable units of meaning. 4. Text will then be organised into categories containing multiple units of meaning that are similar. 5. These categories will elucidate the major themes of the data, the major themes of nurses experiences around adhering to paediatric pain management guidelines. 8
  9. 9. Data presentation Thematic analysis data will be presented in table form and in rich descriptive text, especially quotes, to illustrate the views of participants. For example: 9 Encourages adherence Discourages adherence Theme 1 27% Theme 3 75% Theme 2 56% Theme 4 5% “Children and parents were more relaxed when we followed the guidelines” “We don’t have time to fill out 30 different forms for every patient on every shift!”
  10. 10. Any questions? 10
  11. 11. References Bernhofer, E. (2011). Ethics: ethics in pain management and assessment in hospitalized patients. The online journal of issues in Nursing, 17(1). doi: 10.3912/OJIN.Vol17No01EthCol01 Habich, M., Wilson, D., Theilk, D., Melles, G., Crumlett, H., Masterton, J., & McGuire, J. (2012). Evaluating the effectiveness of pediatric pain management guidelines. Journal of Pediatric Nursing, 27(4), 336-345. doi:10.1016/j.pedn.2011.06.002 Kafle, N. P. (2011). Hermeneutic phenomenological research method simplified. Bodhi: An interdisciplinary journal, 5, 181-200. Retrieved from 0Research%20Method.pdf Kozlowski, L. J., Kost-Byerly, S., Colantuoni, E., Thompson, C. B., Vasquenza, K. J., Rothman, S. K., Billett, C., White, E. D., Yaster, M., & Monitto, C. L. (2014). Pain prevalence, intensity, assessment and management in a hospitalized pediatric population. Pain Management Nursing, 15(1), 22–35. doi: 10.1016/j.pmn.2012.04.003 Twycross, A & Collins, S. (2011). Nurses views about the barriers and facilitators to effective management of pediatric pain. American Society for Pain Management Nursing, 14(4), 164-172. doi:10.1016/j.pmn.2011.10.007 Werner, G. (2007). Exploratory designs. In Werner, G. Collecting spatial data (3rd ed.). (pp. 77-99). NY: Springer. 11