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Theory-practice gap in paediatric pain management. Ghanaian nursing tutors’ and nursing students’ perspectives

Published onJun 16, 2023
Theory-practice gap in paediatric pain management. Ghanaian nursing tutors’ and nursing students’ perspectives

Many children who visit the emergency department present with pain during evaluation and treatment of their condition. Pain in children is reportedly undertreated. Inadequate treatment of pain in children can result in many negative patient outcomes. Over the past decade, efforts have been made to improve pain management through increased research, technological advancement, and the development of readily available clinical guidelines. However, this knowledge has not been effectively translated into practice. Moreover, there is inconsistencies between nurses’ theoretical knowledge and what they do in practice. The study aimed to explore the gap between what students are taught in class and what they practice in the wards with regards to paediatric pain management. A descriptive qualitative design was employed for the conduct of this study. Sampling involved nursing tutors and nursing students. For the tutors, total population sampling was employed (31), while for students a convenient sample was used to garner 24 third year students in one Ghanaian nursing school. Data were collected via focus-groups and analysed drawing on Braun and Clark’s thematic analysis. Findings from the tutors’ focus-groups revealed inadequate practice for students in use of pain assessment scales in the hospital wards. This is compounded by the lack of formal pain assessment in the Ghanaian healthcare system thus making it challenging for students to observe and learn pain assessment from clinicians and for them to subsequently improve their own practise. Tutors also reported some students pick up bad practices from nurses in the wards because standards set in the theoretical context were not always observed in practice. Students focus-groups revealed gaps between theory and practice as they had observed inadequacies in practice in terms of pain assessment, pharmacological and non-pharmacological pain management as compared to the standards they had learnt in the classroom. These findings highlight the importance of clinicians in the training of student nurses, it is therefore imperative that their practice is up to date to enhance students’ learning. Implementation of an evidence-based policy guidelines on pain management in the Ghanaian healthcare system can be a key to ensure standardised practice in the wards by clinicians.

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