Prior conditions influencing nurses' decisions to adopt evidence-based postoperative pain assessment practices

Over the last 30 years, postoperative pain relief has been shown to be inadequate. In order to provide postoperative pain relief, it is imperative for registered nurses to use evidence-based postoperative pain assessment practices. This correlational descriptive study was conducted to test selected elements of Rogers' Diffusion of Innovations (2003) model by identifying factors, termed prior conditions, that influenced registered nurses' decisions to adopt evidence-based postoperative pain assessment practices. A convenience sample of all nurses who cared for adult postoperative patients in two metropolitan hospitals in the Midwest comprised the sample for this study. Data was collected via a survey in booklet form and 443 (46.9%) booklets were returned.; Respondents were aware of but not using three evidence-based post-operative pain assessment practices consistently. Registered nurses' previous practices and norms of the social system were supportive of adoption of the three practices. Nurses felt patients received adequate pain relief, which is unsupportive of adoption of the three practices as there is no impetus to change. Significant, though weak, correlations were found between the level of adoption of the three practices and (a) the prior conditions and (b) selected characteristics of nurses. Nurses who perceived the prior conditions as being supportive of adoption of pain management practices, who used multiple sources to identify solutions to clinical practice problems, and read professional nursing journals were more likely to have adopted the three practices. Registered nurses who regularly read professional nursing journals and used more sources to identify solutions to clinical practice problems were more innovative. Although accounting for a small portion of the variance, the number of sources used to identify solutions to clinical practice problems, previous practices, and innovativeness were predictive of registered nurses' adoption of three evidence-based postoperative pain assessment practices.; Registered nurses need to be encouraged to use multiple sources to identify solutions to clinical practice problems including professional nursing journals. Innovative nurses may be considered opinion leaders and need to be identified to promote the adoption of evidence-based postoperative pain assessment practices. Further exploration of the large unexplained variance in adoption of evidence-based postoperative pain assessment practices is needed.