Assessment of Pain Management Competencies Among Critical Care Nurses in Pediatric Wards

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 179–188

DOI: 10.46882/2026/AJNM/000152

Original Research Article

Title: Assessment of Pain Management Competencies Among Critical Care Nurses in Pediatric Wards

Names of Authors: Selamawit G. Mengistu¹, John M. Ndwiga²

Authors’ Affiliations:
¹School of Allied Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
²Neonatal Intensive Care Unit, Kenyatta National Hospital, Nairobi, Kenya

Abstract:
Accurate pediatric pain relief remains a major challenge in intensive care environments due to communication limits and unstandardized medication practices among bedside personnel. This multi-site cross-sectional study investigated pediatric pain assessment knowledge, therapeutic behaviors, and structural barriers among critical care nurses. A sample of 145 pediatric ICU nurses completed the Pediatric Pain Knowledge and Attitudes Questionnaire (PPKAQ), backed by observational audits of pain charting behaviors. The mean correct score on the PPKAQ was 54.8% (SD = ±6.1). Critical knowledge deficits were noted regarding opioid calculation rules and distinguishing infant withdrawal signs from active pain cues. Observational indicators showed that valid pediatric scaling choices (such as the FLACC scale) were regularly deployed in only 36.6% of monitored shift assessments. Prominent structural barriers identified included an absolute lack of clinical autonomy for nurses to adjust analgesic dose boundaries (78.2%) and inconsistent medical provider orders. Advanced specialty certifications significantly predicted superior clinical pain tracking scores (p < 0.005). Developing expert pediatric ICU workflows requires updating advanced nurse pain training and creating collaborative clinical autonomy paths.

Keywords: Pediatric Pain; Critical Care Nursing; FLACC Scale; Analgesic Management; Clinical Competence; Intensive Care.

Manuscript Timeline: Received July 05, 2026; Revised August 22, 2026; Accepted September 08, 2026; Published September 21, 2026.

Citation: Mengistu, G. S., & Ndwiga, J. M. (2026). Assessment of Pain Management Competencies Among Critical Care Nurses in Pediatric Wards. African Journal of Nursing and Midwifery, 14(9), 179–188. DOI: 10.46882/2026/AJNM/000152

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