Poster Presentation Clinical Oncology Society of Australia 2014 Annual Scientific Meeting

A complex Qstream© pain assessment intervention on cancer nurses’ pain screening and assessment practices: results from a quasi-experimental study. (#230)

Jane L Phillips 1 2 , Nicole Heneka 1 2 , Lawrence Lam 3 , Tim Shaw 4
  1. University of Technology Sydney, Ultimo, NSW, Australia
  2. University of Notre Dame Australia, Darlinghurst Campus, NSW, Australia
  3. Department of Health and Physical Education , The Hong Kong Institute of Education, Hong Kong SAR, , CHINA
  4. Director, Workforce Education and Development Group (WEDG), Sydney Medical School, The University of Sydney, Sydney, NSW, AUSTRALIA

Background:
Routine cancer pain screening and assessment is the foundation upon which effective pain management is built. Whilst these simple practices are recommended in all evidence based cancer pain guidelines, they are often not routinely implemented, resulting in undetected and undertreated cancer pain in people living with cancer. This translational research study utilised a novel online performance feedback intervention to improve cancer nurses’ pain assessment practices.
Aim:
To measure the impact of a tailored Qstream© cancer pain assessment performance feedback intervention on inpatient cancer nurses’: i) pain assessment capabilities; and ii) adherence to cancer pain screening and assessment guideline recommendations.
Methods:
A quasi-experimental, prospective follow-up study involving specialist cancer nurses in five acute care settings within one translational cancer research network in Australia. Participant survey and patient chart audit data were collected: pre (T1) and post (T2-T3) intervention, with final chart audit 4 weeks (T4) post audit and feedback. Participants’ completed 11 case based pain assessment scenarios delivered to their nominated email using a spaced learning format, with the T1-T2 pain assessment chart audit data fed back to participants at T3.
Results:
Participants who completed the intervention (n=44) increased their pain assessment knowledge, assessment tool knowledge and confidence to undertake a pain assessment (p<0.001), with this change maintained at 10 weeks post intervention. The positive changes in nurses’ pain assessment capabilities’ translated into a significant increasing linear trend in the proportion of documented pain assessments in patients' charts at three time points (χ2 trend =18.28, df=1, p<0.001). The median pain assessment documentation quality scores also increased during the study period (Kruskal- Wallis test χ21 =7.17, p=0.007)].
0>Conclusions:
Integrating specialised pain assessment clinical content and audit and feedback into a spaced on-line learning platform improved cancer nurses’ pain assessment practices. These results need to be confirmed in a controlled study.