Factors Influencing Nurses' Adherence to Pain Management Protocols: A Cross-Sectional Study in Two Secondary Hospitals, Nigerian

Background: Pain remains a prevalent and distressing experience for hospitalized patients, frequently underscored by suboptimal management. Nurses are pivotal to pain relief, yet their adherence to management protocols is often mediated by a complex interplay of personal, patient-related, and institutional factors. Objective: This study investigated the determinants influencing nurses' adherence to pain management protocols within the Nigerian healthcare context. Methods: A descriptive cross-sectional design was utilized to survey 167 nurses across various medical units in two selected secondary hospitals in Delta State. Data were obtained through a structured survey evaluating socio-demographic characteristics, knowledge, attitudes, clinical applies, and perceived barriers. Analysis was achieved using descriptive and inferential statistics, including t-tests and chi-square analyses, with significance set at p < 0.05. Results: High workload emerged as a critical barrier, significantly limiting the frequency of pain assessments (Mean = 3.10, SD = 0.78, p< 0.001). Deficits in continuous professional development were evident, as inadequate training on contemporary protocols negatively impacted clinical practice (Mean = 2.68, SD = 0.98, p = 0.007). Institutional resource constraints, specifically the shortage of essential analgesics, were strongly associated with hindered management outcomes (Mean = 3.45, SD = 0.74, p ˂ 0.001). Furthermore, inter professional collaboration was a positive predictor, with physician cooperation significantly improving protocol adherence (Mean = 2.74, SD = 0.97, p = 0.002). The implementation of electronic health records demonstrated no statistically significant influence on adherence levels (Mean = 2.37, SD = 1.03, p = 0.125). Conclusion: Nurses' adherence to pain management protocols is multifaceted, driven primarily by workload intensity, educational preparation, resource availability, and the quality of interprofessional relationships. Strengthening protocol-based care requires targeted interventions focusing on staff support, mandatory continuous education, and the consistent provision of pharmacological resources to optimize patient outcomes.