Thesis:

Determinants of pain assessment on critically ill patients by nurses at selected hospitals of Kiambu county Kenya

The incidence of pain is projected to vary between 47% and 100%, posing a significant challenge across all ages, races, genders, diverse economic backgrounds, and geographical locations. Inadequate pain assessment may delay numbness management and lead to heightened anguish, anxiety, and nervousness, potentially exacerbating pain. Nurses bear both professional and ethical responsibilities to ensure effective pain relief for their patients. Achieving optimal pain relief relies on nurses’ understanding of pain, systematic and consistent assessment, and documentation of pain. The primary aim of this study is to assess pain assessment practices for critically ill patients among nurses in selected hospitals in Kiambu County, Kenya. Specific objectives include evaluating the pain assessment tools used, identifying institutional factors influencing pain assessment, and understanding nurses’ factors affecting pain assessment. This research utilized analytical descriptive research design focusing on 196 nurses working in selected hospitals in Kiambu County, Kenya. The census technique was employed to select participants, and a structured questionnaire was administered. Data were analyzed using Statistical Package for the Social Sciences (SPSS) Version 22, with descriptive statistics, standard deviation, mean, percentages, tabulations, and frequencies. Findings revealed that selected hospitals in Kiambu County employ various pain assessment tools for critically ill patients, with the most common being the behavioral pain assessment tool, followed by the critical-care pain observational tool and nonverbal pain assessment tool. Institutional factors such as pain evaluation procedures, internal communication channels, staffing levels, availability of equipment, teamwork, supervision, work regulations, and hospital environment significantly influenced pain assessment. Furthermore, nurses’ demographic factors including experience and personal encounters with pain influenced pain assessment practices. Statistical analysis demonstrated a significant relationship between pain assessment tools and outcomes, emphasizing the importance of tool selection for effective pain management. The study concludes that the type of tools, institutional factors, and nurses’ characteristics influence the assessment and management of chronic pain among critically ill patients in Kiambu County. To ensure balanced tool utilization, the County Health Department should implement capacity-building programs for nurses, while hospital management should prioritize staffing, ethical nursing practices, equipmentprovision, work culture, and safety. Given the influence of personal factors on pain assessment practices, the study recommends incorporating pain management education into initial and ongoing training for all healthcare practitioners