A Study to Evaluate the Effectiveness of a Training Program on Clinical Decision-Making Regarding Postoperative Pain Management in Terms of Clinical Decision-Making Ability Among Nurses in Selected Tertiary Care Hospitals

Abstract

The research was undertaken to determine the effectiveness of a structured training program designed to enhance nurses' clinical decision-making abilities in the management of postoperative pain.The primary objective of the study was to examine whether a structured training program could improve nurses' clinical decision-making abilities related to postoperative pain management. In addition, the study aimed to develop and validate the training program, evaluate its impact on both perceived and actual clinical decision-making abilities, assess patient satisfaction with postoperative pain management, examine the opinions of health care providers regarding nurses' performance, and identify factors influencing clinical decision-making among nurses. The investigation employed a randomized controlled trial with cluster randomization in a tertiary care hospital setting. A total of 175 staff nurses from 16 clinical wards participated in the study. The intervention consisted of an 18-hour structured training program developed using adult learning principles to encourage active participation and practical application of knowledge. Reinforcement sessions were conducted following the training. Data were collected at baseline and during three follow-up assessments using validated instruments, including structured questionnaires, observation checklists, clinical case studies, patient satisfaction scales, and opinionnaires. The results indicated that nurses who participated in the training program demonstrated a significant improvement in their actual clinical decision-making ability related to postoperative pain management. Patients receiving care from trained nurses reported greater satisfaction with pain relief, the quality of nursing care, information provided regarding pain management, pain medications, and the overall management of postoperative pain. Health care providers also expressed more favorable opinions about the clinical performance of nurses who had undergone the training. However, the intervention did not produce a significant improvement in nurses' perceived clinical decision-making ability, possibly because most participants already considered themselves competent in this area before the intervention. Furthermore, no significant association was identified between nurses' actual clinical decision-making ability and the factors they perceived to influence their decision-making process. The study concluded that the structured training program was successful in strengthening nurses' actual clinical decision-making skills in postoperative pain management and contributed to improved patient satisfaction. These findings support the integration of structured clinical decision-making training into undergraduate nursing curricula as well as continuing nursing education and in-service training programs. Such educational initiatives can promote evidence-based clinical practice, enhance professional competence, and ultimately improve the quality of postoperative patient care.