Barriers to effective pain management.

In this article my sole aim is to engage the reader to think about the management of pain in a different way. I have deliberately taken a less formal style but provided references if you are interested in following up. The management of pain has often been assumed to be a routine part of care, in fact in the perioperative arena it is the second most common nursing intervention (Juntilla et al 2005). Despite this activity, pain after surgery has been reported to be a consistent problem which has spanned several decades (Marks & Sachar 1973, Wu et al 2002, Ekstein et al 2006). The reasons for this are well documented and include: patient barriers, inadequate knowledge of healthcare professionals, lack of assessment and organisational practices which impede the administration of analgesics and non-pharmacological interventions. Despite this knowledge the changes required in practice are not necessarily forthcoming. The purpose of this paper is to explore the patient, professional and organisational barriers which affect the optimal management of pain in the perioperative period, and provide some practical solutions to help you think about and manage pain more effectively.