Nurses' perspectives on providing analgesia in the Italian prehospital emergency setting: A phenomenological study.

BACKGROUND

Effective pain management is a fundamental aspect of prehospital emergency care. However, numerous barriers, including inconsistent protocols, limited pharmacological options, and documentation gaps, hinder optimal pain relief. Emergency medical services (EMS) nurses play a crucial role in assessing and managing pain, yet their perspectives on prehospital analgesia remain underexplored.

OBJECTIVE

This study aims to explore the experiences and perceptions of Italian EMS nurses regarding prehospital pain management, identifying key challenges and potential improvements.

METHODS

A qualitative study was conducted using an interpretative phenomenological approach. Semi-structured interviews were performed with 14 EMS nurses from various Italian regions. Data was analyzed through thematic analysis, identifying recurring themes related to pain assessment, treatment, and documentation.

RESULTS

Five main themes emerged: (1) variability in analgesia protocols and pharmacological options, (2) inconsistent pain assessment and documentation, (3) challenges in pain management related to specific patient populations or environmental and logistical factors, (4) nurses' personal experiences shaping their approach to pain management, and (5) interprofessional collaboration challenges. While nurses emphasized the importance of systematic pain evaluation, barriers such as legal restrictions, inconsistent protocols, and limited pharmacological options were frequently reported.

CONCLUSION

Prehospital pain management by EMS nurses in Italy faces significant challenges. Expanding protocol-approved pharmacological options, improving documentation practices, and enhancing training for pain management in vulnerable populations could improve care. A standardized, evidence-based national framework is needed to optimize pain relief and ensure equitable patient outcomes.