The Influence of Context on Utilizing Research Evidence for Pain Management in Jordanian Pediatric Intensive Care Units

Abstract

Background: Little is known about the use of pain management evidence in Jordanian Pediatric Intensive Care Units (PICUs). Purpose: To assess the existence, content, and the factors influencing the use of pain management evidence in Jordanian PICUs. Methods: Three studies were guided by the Promoting Action on Research Implementation in Health Services (PARiHS) framework. 1. A scoping review of the literature to identify pain management interventions in the PICU; 2. A cross-sectional and multisite survey to determine the current pain management practices, and the availability and content of practice guidelines in Jordanian PICUs; 3. A correlational and multisite survey to examine the relationship between the contextual factors and nurses’ use of pain management research evidence in Jordanian PICUs. Results: 1. Twenty-seven studies were included in the scoping review. The majority of the studies focused mainly on pharmacological interventions (n= 21, 78%). Morphine and fentanyl were the most commonly used pharmacological agents for pain management in the PICUs. The use of non-pharmacological interventions was limited. 2. Four of six eligible PICUs participated in the cross-sectional study. All four units had written pain management guidelines. Fentanyl was the most commonly used pharmacological agent in two units. Intravenous infusions of opioids were not administered for patients on mechanical ventilation in two units. The use of non-pharmacological interventions was reported in one unit. 3. From the four participating units, 73 nurses completed the correlation study survey. Social capital predicted both the instrumental and conceptual research use for pain management by Jordanian PICU nurses. Structural and electronic resources predicted the instrumental research use for pain management by Jordanian PICU nurses. Conclusions: Pain management practices and supporting guidelines varied in Jordanian PICUs. Context influences Jordanian PICU nurses’ use of research for pain management. Not all of the pain management practices in Jordan are evidence informed. There is an opportunity for improvement in pain management in Jordanian PICUs.