Analgesic decision-making skills of nurses.

Administration of analgesics is a common nursing intervention for providing pain relief to patients with cancer. A sample of 177 nurses participated in a study to examine their decision-making skills when analgesic orders were changed. Nurses were given four clinical vignettes and reference materials to assist them in responding to the vignettes. Twenty-six percent of 708 responses provided by the nurses were answered correctly. Twenty-nine percent of the sample answered all four vignettes incorrectly. The majority (44%) answered only one vignette correctly. No statistically significant differences were found between correct answers and type of work setting, academic preparation, number of patients with cancer cared for per week, number of years employed as a nurse, recent clinical experience with the analgesics used in the vignettes, or the use of reference materials. These findings raise concerns that patients requiring analgesics may not receive an amount that adequately relieves their pain or avoids unnecessary toxicity.