Date of Conferral



Doctor of Nursing Practice (DNP)




Sue Bell


Chronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses' knowledge of pain assessment and management in a 45-bed Veterans Health Administration long-term care facility serving older adults with dementia. Knowles' adult learning theory served as the theoretical framework and the knowledge to action model supported the translation of evidence into practice. A convenience sample of 27 licensed and unlicensed nursing staff answered the 16-question, 5-point Likert scale survey, Self-Assessment of Knowledge in Assessing Pain in Dementia Patients and 7 demographic questions. Data analysis was conducted using a one way ANOVA. Knowledge of best practices for pain assessment and management varied significantly by job title; RNs had the highest knowledge mean score (M = .74), followed by LPNs (M = .54), and then by CNAs (M = .40; p < .001). Similarly, nurses with an associate degree or higher had better knowledge (M = .74) than nurses without an associate degree (M = .42; p < .001). Knowledge was unrelated to years of employment in long-term care. However, 85% of the nurses believed pain was assessed and managed correctly in the facility. These data suggested that nurses' assessment and management of pain may be disconnected to their self-assessment knowledge scores. Positive social change may be realized as the project findings are used to develop education for the nursing staff related to the knowledge deficits identified by the survey and application of an evidence-based tool to assess pain in cognitively-impaired older residents.

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