Impact of a novel online learning module on specialist palliative care nurses' pain assessment competencies and patients' reports of pain: Results from a quasi-experimental pilot study

Jane L Phillips; Nicole Heneka; Louise Hickman; Lawrence Lam; Tim Shaw

doi:10.1177/0269216314527780

Impact of a novel online learning module on specialist palliative care nurses' pain assessment competencies and patients' reports of pain: Results from a quasi-experimental pilot study

Palliat Med. 2014 Jun;28(6):521-529. doi: 10.1177/0269216314527780.

Authors

Jane L Phillips^{1

2}, Nicole Heneka², Louise Hickman³, Lawrence Lam^{4

5}, Tim Shaw⁶

Affiliations

¹ 1 School of Nursing, Sydney, The University of Notre Dame, Australia, Sydney, NSW, Australia.
² 2 Cunningham Centre for Palliative Care, Sydney, NSW, Australia.
³ 3 Faculty of Health, University of Technology, Sydney, Sydney, NSW, Australia.
⁴ 4 Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong SAR, China.
⁵ 5 Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
⁶ 6 Workforce Education and Development Group (WEDG), Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.

PMID: 24685649
DOI: 10.1177/0269216314527780

Abstract

Background: Pain is a complex multidimensional phenomenon moderated by consumer, provider and health system factors. Effective pain management cuts across professional boundaries, with failure to screen and assess contributing to the burden of unrelieved pain.

Aim: To test the impact of an online pain assessment learning module on specialist palliative care nurses' pain assessment competencies, and to determine whether this education impacted positively on palliative care patients' reported pain ratings.

Design: A quasi-experimental pain assessment education pilot study utilising 'Qstream^©', an online methodology to deliver 11 case-based pain assessment learning scenarios, developed by an interdisciplinary expert panel and delivered to participants' work emails over a 28-day period in mid-2012. The 'Self-Perceived Pain Assessment Competencies' survey and chart audit data, including patient-reported pain intensity ratings, were collected pre-intervention (T1) and post-intervention (T2) and analysed using inferential statistics to determine key outcomes.

Setting/participants: Nurses working at two Australian inpatient specialist palliative care services in 2012.

Results: The results reported conform to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Guidelines. Participants who completed the education intervention ( n = 34) increased their pain assessment knowledge, assessment tool knowledge and confidence to undertake a pain assessment ( p < 0.001). Participants were more likely to document pain intensity scores in patients' medical records than non-participants (95% confidence interval = 7.3%-22.7%, p = 0.021). There was also a significant reduction in the mean patient-reported pain ratings between the admission and audit date at post-test of 1.5 (95% confidence interval = 0.7-2.3) units in pain score.

Conclusion: This pilot confers confidence of the education interventions capacity to improve specialist palliative care nurses' pain assessment practices and to reduce patient-rated pain intensity scores.

Keywords: Palliative care; education–professional; inpatient; intervention; learning; nurses; pain assessment; patient-centred outcome research; teaching materials; translational medical research.