Testing an Educational Nursing Intervention for Pain Assessment and Management in Older People

Objective. This study aimed to examine the effectiveness of a structured educational nursing intervention on pain assessment and management in older hospitalized people. Design. A non-equivalent control group interventional design. Setting. Geriatric evaluation and management units in two metropolitan Australian hospitals. Patients. In total, 192 patients participated, with 32 different patients recruited consecutively for the pre-intervention, intervention, and 3-month post-intervention stages from each unit. Interventions. Nurses in the intervention group received a structured intervention comprising 6 hours of instruction and 2 hours of clinical demonstration. Nurses in the control group received "usual" staff development activities. Outcome Measures. Five assessment tools for pain were used: the visual analog scale, the Faces Pain Scale-Revised, the Short-Form McGill Pain Questionnaire, the Pain Assessment in Advanced Dementia Tool, and the Abbey Pain Scale. Data were also collected on nurses' use of pain assessment tools and their use of non-pharmacological and pharmacological methods of managing pain. Results. Improvements were observed in pain intensity at rest and on movement in the intervention unit at the post-intervention stage and at the 3-month post-intervention stage. There was also a trend for patients to be prescribed analgesics on a fixed dose schedule following implementation of the program in the intervention unit. Conclusions. The comprehensive intervention enabled change in practice and improvements in pain intensity, and the assessment and management of pain. Future research is needed on implementing the intervention with a multidisciplinary team of health professionals in a subacute environment.