Pain Assessment and Management in Intensive Care Unit: Nurses' Practices, Perceived Influencing Factors, and Educational Needs

Malek Kh. Alnajar1, *, Raed Shudifat2, Sultan M. Mosleh1, 2, Samantha Ismaile1, Monther N'erat3, Khadijah Amro4
1 Department of Health Sciences, Nursing Program, Higher Colleges of Technology, United Arab Emirates
2 Department of Clinical Nursing, Faculty of Nursing, Mutah University, Mutah, Jordan
3 Albasheer Hospital, Amman, Jordan
4 Al-Kindi Hospital, Amman, Jordan

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 162
Abstract HTML Views: 39
PDF Downloads: 75
Total Views/Downloads: 276
Unique Statistics:

Full-Text HTML Views: 106
Abstract HTML Views: 30
PDF Downloads: 58
Total Views/Downloads: 194

Creative Commons License
© 2021 Alnajar et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Health Sciences, Nursing Program, Higher Colleges of Technology, Al-Sharjah, United Arab Emirates; Tel: 0504326561; E-mail:



Critically ill patients and those mechanically ventilated or unable to communicate may not be able to report any pain they experience. Consequently, pain assessment and management (PAM) is challenging and underestimated in intensive care units (ICUs), where patients suffer alteration of consciousness, sedation, invasive procedures and mechanical ventilation.


This study aimed to investigate ICU nurses’ PAM practices, their perceptions of influencing factors, and their related educational needs.


A descriptive cross-sectional design was employed, using a valid self-reported questionnaire.


Among the sample of 171 nurses, 55% were male and 83% held a bachelor’s degree. 60% reported performing pain assessment for patients able to report pain and 50% for those unable to do so. Almost 40% of participants reported that pain management plans and scores were not discussed in medical rounds. Workload and lack of guidelines were reported as the most common barriers to PAM, while the most common enablers were perceived to be prescribing analgesia and considering pain a priority. Nurses recognized the need for education regarding pain, especially the physiological (50%) and psychological (47%) consequences of untreated pain.


Nurses’ reported performance of pain assessment for ICU patients remains suboptimal. Therefore, healthcare professionals, organizations, nursing schools, and policymakers should work together to improve nurses’ PAM knowledge and practices.

Keywords: Educational needs, Intensive care, Nurse, Pain, Pain assessment, Management.