Emergency nurses perceived barriers to effective pain management at emergency department in Amhara region referral hospitals, Northwest Ethiopia, 2021. Multi-center cross sectional study.

Background: Quality of pain management in emergency departments may be affected by nurses' perceived barriers. Poorly managed pain may lead to altered physiological and psychological function which affect patients' quality of life as well as increase costs to the health care system.

Objective: This study aimed to assess emergency nurse's perceived barriers to pain management and associated factors at emergency departments, 2021.

Methods: A multi-center cross-sectional study was conducted with 153 nurses from eight emergency departments from May1-May 30, 2021 with semi-structured questionnaire. All volunteer nurses were included. Epi-info version 7 and SPSS version 20.0 were used for data entry and analysis respectively. We used descriptive statistics to report results of the study in the form of text and table. Student t-test, one way ANOVA and Post hoc test were applied to assess relationship between socio-demographic characteristics of the participants with perceived barriers.

Result: Of the 20 items, overcrowding 3.24 ± 0.9, nursing workload 3.16 ± 1.03, and lack of pain management guidelines/protocol2.5 ± 1.15 were the highest reported barriers to pain management at an emergency department. In addition, years of work experience as emergency nurses1 (p-value = 0.01), BSC level of education (p-value = 0.04), married (p-value = 0.04) and frequency of training ≤ (p-value = 0.02) were significantly associated with nurses perceived barriers on pain management.

Conclusion: and Recommendation: Overcrowding, nurses' workload, absence of pain management tool, year of experience as emergency nurse ≤1, married, BSC nurses and frequency of training1 were the perceived barriers to pain management in the emergency department. The stakeholders in each facility should make an effort to increase the ratio of nurses to emergency patients. Professionals should develop local pain assessment and management protocol. Training should be given regularly and the opportunity of education should be maximized.