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Pain Assessment Clinical Practice Improvement: An Educational Approach in the Home Healthcare Setting
Chris Chimenti1, John McIntyre, Brigid Noonan
1Chris Chimenti, MS, PT, is a Senior Director of Clinical Innovation, HCR Home Care, Rochester, New York. John McIntyre, MD, is Medical Director, HCR Home Care, Rochester, New York. Brigid Noonan, PhD, is Dean, School of Health & Human Sciences, Nazareth College, Rochester, New York. Louise Woerner, MBA, is Chairwoman and Chief Executive Officer, HCR Home Care, Rochester, New York. Marie Bell, EdD, MS, BSN, is an Assistant Professor of Nursing, Nazareth College, Rochester, New York. Carol Marchetti, PhD, MS, is a Professor, School of Mathematical Sciences, Rochester Institute of Technology, Rochester, New York.
Abstract:
In the 2 decades since The Joint Commission on Accreditation of Healthcare Organizations designated pain as the fifth vital sign, practitioners have become increasingly aware of the numerous challenges associated with the assessment and management of pain in older adults. Comprehensive pain assessment relies not only on the availability of assessment tools, but also on a clinician's knowledge, training, prior experience, and keen awareness of their own implicit bias and how it may influence their assessment and decisions. The purpose of this project was to develop, implement, and evaluate outcomes of a two-part online learning module on home healthcare clinicians' knowledge of pain. A quasi-experimental, one-group pretest posttest design was used. Of the 94 clinicians who volunteered, 54 participants completed all modules and surveys. Mean posttest scores (58.7%) were significantly higher than pretest scores (50.7%; n = 54, T = 3.08, p-value = 0.003). The strongest gains in learning occurred for those with lower pretest scores. The mean difference between posttest and pretest scores did not vary among job titles. There was no significant difference in posttest scores among job titles. A higher mean pretest score was associated with greater years of clinical experience, but did not significantly affect mean posttest scores. These findings suggest elearning is an effective educational approach to improve home healthcare clinicians' pain knowledge, particularly those who lack a sufficient knowledge base at the outset.
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