Barriers to Pediatric Postoperative Pain Management-Interprofessional Focus Group Interviews.

Abstract

Background: Historically, postoperative pain management of children in hospitals has been inadequate, despite advancements in pain physiology and management. Postoperative pain correlates with increased complications, psychological harm, and parental stress, leading to inefficiencies in resource utilization and prolonged hospital stays. Effective pain management relies on organizational, collaborative, and individual efforts, with interprofessional communication and cooperation being crucial.

Aim: This study aims to explore healthcare professionals' experiences with barriers to effective pediatric postoperative pain management through interprofessional focus group interviews, aiming to address gaps in understanding and improve care.

Methods: Data collection was performed using focus group interviews with twelve healthcare professionals from four surgical wards. Interviews were audio-recorded and transcribed verbatim. Transcriptions were coded and analyzed using reflexive thematic analysis by two researchers independently.

Results: Our study aligns with prior research on barriers, revealing issues such as lack of competence among physicians and nurses, limited availability of skilled personnel, heavy workloads, and absence of standardized protocols. These barriers largely reflect resource limitations and resonate with existing literature. Additionally, our findings highlight differences in perceptions between nurses and physicians regarding opioid use and standardized pain assessment tools, underscoring potential barriers to optimal pediatric postoperative pain management.

Conclusions: Our study underscores the importance of adhering to standardized, evidence-based pain management protocols, revealing a link to inadequate leadership at the hospital and department levels. Noncompliance may stem from professional inexperience and lack of trust between healthcare professionals, necessitating interprofessional dialogues facilitated by leaders to foster a culture of evidence-based pediatric care.

Clinical implications: Establishing best practices and ensuring adherence is a leadership responsibility. Furthermore, a lack of adherence to established routines of pain management might be a consequence of professional inexperience and lack of competence, as well as a symptom of lack of trust between professions and professionals. It is important that leaders of both nurses and physicians facilitate arenas for discussing these topics. A culture of evidence-based PPPM needs to be interprofessional and inclusive of different perspectives and facilitate open discussions.