Table 3.

Barriers to the implementation of the WHO pain ladder-based trauma pain protocol at EDs of CHUK and CHUB, N=23.

Variable	Number (%)
Respondents per hospital CHUB Doctors Nurses CHUK Doctors Nurses	4 (17.4) 7 (30.4) 3 (13.1) 9 (39.1)
Staff related barriers Inadequate experience and time constraints Inadequate experience with pain control Reluctant to use opioids Poor communication skills with patients Inadequate pain assessment	1 (4.3) 10 (43.1) 4 (17.3) 2 (9) 2 (9)
Hospital related barriers Limited staff Poor documentation Inadequate use of available pain management protocols and guidelines	4 (17.3) 13 (56.5) 12 (52)
Patients related barriers Reluctance to report pain Reluctance to take analgesics Poor communication with medical staff	14 (60) 9 (40) 9 (40)

CHUK: University Teaching Hospital of Kigali, CHUB: University Teaching Hospital of Butare