Differences in pain measurement between nurses and physicians in a teaching hospital

Abstract

Introduction: In clinical practice, the administration of opioid analgesics depends on pain severity records from nurses because they are responsible for determining the severity of the patient's complaints; however, discrepancies regarding pain measurement are often observed between physicians and graduated nurses, which can lead to an inadequate use of analgesics.Objective: To carry out a comparison of pain severity measurements made by staff physicians and nurses in a teaching hospital during the first 24 hours of hospital stay of patients with movement-related pain.Methods: Retrospective, cross-sectional study. Data were obtained from the pharmacy database and medical records (opioids prescribed for 1 month, pain intensity, and medication management). The medical records of 634 in patients who were prescribed at least 1 dose of an opioid analgesic were reviewed.Results: The average pain score provided by physicians (5.4/10; SEM=0.17) was significantly higher than the average pain score reported by nurses (3.5/10; SEM=0.15) (p<0.05). The intra-class correlation coefficient was 0.371 (95%CI: 0.138-0.563), indicating poor agreement between measurements.Conclusion: A poor agreement between pain measurements made by physicians and nurses during the first 24 hours of hospital stay was found. Bearing in mind that pain measurement is essential for achieving an appropriate treatment, the jointly provision of pain management education programs to doctors and nurses should be considered, so that they assess pain severity similarly, thus improving the management of inpatients and their quality of life.