Addressing Educational Needs in Managing Complex Pain in Cancer Populations: Evaluation of APAM: An Online Educational Intervention for Nurses. (July 2019)

• Record Type: Journal Article
• Authors: Leung, Yvonne W.; Wong, Jiahui; Kiteley, Cathy; Ellis, Jerusha; Esplen, Mary Jane
• Is Part Of: American journal of hospice & palliative care. Volume 36:Number 7(2019)
• Page Start: 587
• Page End: 597
• Publication Date: 2019-07
• Subjects: online learning -- pain management -- cancer -- pain assessment -- continued education and training -- and nurses; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909119832819
• Languages: English
• ISSNs: 1049-9091

Abstract

Context: Cancer-related pain is associated with significant suffering and is one of the most challenging symptoms to manage. Studies indicate that front-line clinicians often lack the knowledge on best practices in cancer pain management. Objectives: The current project, a quality improvement (QI) initiative, evaluated the outcome of an online educational intervention for nurses on complex cancer pain management. Methods: An online 7-module educational intervention, Advanced Pain Assessment and Management, was offered from 2012 to 2017. Pre–post course evaluations included self-reported knowledge and confidence across cancer pain management domains. In-course competency assessments included knowledge examination, online discussion forum participation, opioid dosage calculation assignment, and small-group-based case study. A mixed-model statistical analysis was used to assess pre–post course change in pain management confidence level. Results: In all, 306 nurses from 89 hospitals in Ontario, Canada, were enrolled in the course; 81.4% returned the precourse survey and 71.9% successfully completed the course. The average confidence level on pain management was low at baseline (57.5%) but improved significantly post-course. In-course competency assessments ranged from 81% to 89%. Mixed-model results showed post-course improvements in confidence levels, independent of sociodemographic background, clinical role, and professional educational level. Nurses with longer years of practice and more cancer cases reported greater confidence. Conclusion: A facilitator-led online educational intervention focusing on complex cancer pain management can significantly improve nurses' knowledge, confidence, and skills. Low baseline knowledge among nurses highlights the pressing need for health-care organizations to implement cancer pain management training as an integral part of health-care QI initiative.