TitleAn ethnography of the culture of pain in a non-pediatric emergency department
NameCummings, Jo Ann F. (author), Lev, Elise L (chair), Scoloveno, Mary Ann (internal member), mahat, ganga (internal member), Dickson, Geri (outside member), Rutgers University, Graduate School - Newark,
Pain in children,
DescriptionRationale for the Study: Despite the exponential growth in pharmacological and non-pharmacological methods for the treatment of pediatric procedural pain there remains a gap between available interventions and actual practice in the emergency department clinical setting. Researchers have recommended the examination of unit culture since culture is proposed to be a major factor that affects the implementation of pain management practices. Method: Ethnography was employed to gain access to the beliefs and practices of healthcare participants in a Northeastern non-pediatric emergency department. Data were collected for 5 months with over 100 hours of observation. Six key informants were interviewed and 44 pediatric procedural interactions with 27 healthcare providers during the treatment of children two to eight years of age undergoing procedures were observed. Other information gathered included documents from the institution, and pain related information from the patient’s medical record. All interviews were recorded and transcribed verbatim. Data were managed using the Ethnograph 6.0 and analyzed using the procedure developed by Leininger and McFarland (2006). Results: Seven major themes with categories were discovered that included assessment, procedural pain, treatment of pain, communication related to comfort, fragmentation of care in the emergency department, healthcare provider attitudes, and environmental issues and policies. Conclusion: The results of this study suggest that practice environment of the emergency department and organizational culture exerted a significant degree of influence over healthcare providers’ pediatric pain management practices. Nurses’ did not use pain measurement tools as they were intended to be used and instead improvised measurement by observing the child’s behavior. The management of children during painful procedures consisted of an array of behaviors and practices. The use of physical restraint during painful procedures was a common practice. Participants continue to hold many assumptions and misconceptions about pediatric pain assessment and management. The findings of this study provide insight to the everyday practice of emergency department healthcare providers for pediatric pain in a non-pediatric setting.
NoteIncludes bibliographical references
Noteby Jo Ann F. Cummings
CollectionGraduate School - Newark Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.