Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study

Phillips, Jane; Heneka, Nicole; Hickman, Louise; Lam, Lawrence T.; Shaw, Tim

doi:10.1016/j.pmn.2017.01.003

Cited by 25 publications

(63 citation statements)

References 54 publications

(62 reference statements)

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“…Collectively, these studies involved 2701 clinicians (median 59.0 participants/study), with the largest study involving 1470 urologists from 63 countries . Participants included: medical specialists, nurses, primary care providers, flight nurses and paramedics, and public health personnel . Four studies were interdisciplinary (refer to Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Five randomised controlled trials (RCTs) generated the highest level of evidence (level II). Lower levels of evidence emerged from: five pre–post‐test studies, two prospective cohort studies, two quasi experimental studies, one mixed‐methods study, one time series analysis and one standardised patient study …”

Section: Resultsmentioning

confidence: 99%

“…Participants who had undertaken an online spaced education program following a face‐to‐face continuing medical education conference reported increases in confidence when managing patients with diabetes, hypertension, human immunodeficiency virus (HIV) and non‐alcoholic steatohepatitis (NASH) (p‐values all ≤0.001) . Palliative and cancer care nurses’ confidence in undertaking a pain assessment was also significantly higher after completing the online spaced education intervention compared to baseline (p < 0.001) . Spaced education delivered via a repeating programme of face‐to‐face simulation‐based scenarios, versus an online platform, also showed increased confidence (p = 0.002) in paediatric doctors’ and nurses’ management of critical illness scenarios compared to baseline …”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies measured knowledge acquisition (i.e. through changes in participants’ pre‐ and post‐intervention test scores), with 10 studies reporting significantly increased topic‐specific knowledge post‐intervention (Table ) …”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported findings pertaining to knowledge retention (i.e. following spaced education) . One study reported a sustained and statistically significant increase in cancer nurses’ self‐perceived knowledge of pain assessment and a pain assessment tool 10 weeks after completion of an online spaced education module (p < 0.001) .…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

et al. 2019

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Context Ensuring clinical practice reflects current evidence is challenging given the rapid proliferation of new knowledge. Changing entrenched clinical behaviours and facilitating the adoption of best practice evidence requires a range of strategies, including affordable, scalable and effective continuing professional development (CPD). Yet, identifying the CPD delivery method most likely to effectively change and improve patient outcomes is difficult given the variability in the evidence for different learning approaches. Although there is moderate level evidence for outreach education, audit and feedback, and face‐to‐face or online learning, little is known about the capacity of spaced education to change ineffective clinical practice(s). Spaced education harnesses the power of spacing, repetition and testing learning content to increase topic‐specific knowledge. Although spaced education is widely used in undergraduate and postgraduate medical programmes, its effectiveness as a CPD delivery method that improves patient outcomes is less certain. Aim To determine the effectiveness of the spaced education CPD programmes to change targeted clinical knowledge and practice(s) to improve patient outcomes. Method A systematic review, appraising the spaced education CPD evidence generated from searching six specialist medical and psychosocial databases. Studies published in English peer‐reviewed journals from 1 January, 2000 to 31 August, 2018 were eligible for inclusion. A modified Kirkpatrick four levels of evaluation framework assisted with appraising the effect of spaced education CPD interventions on clinicians and patients. Results Of the 2396 studies identified, 17 met the inclusion criteria, involving 2701 practising clinicians from multiple disciplines and specialties. Five randomised controlled trials generated level II evidence, with the remaining 12 studies generating lower levels of evidence. The majority of studies (n = 14) involved the delivery of online spaced education. All studies were evaluated using the modified Kirkpatrick four levels of evaluation framework with: 10 studies demonstrating significant increases in participants’ knowledge; seven studies reporting significant changes in clinician behaviour; four studies showing significant increases in clinician confidence; and three studies identifying significant and sustained increases in participants’ clinical skills. Only two studies reported positive improvements in patient outcomes. Conclusion Spaced education via an online platform offers a scalable CPD format that can increase clinical knowledge and change practice. However, further adequately powered randomised controlled trials are required to confirm that spaced education CPD can impact positively on patients’ reported outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

et al. 2019

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Clinicians’ perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report

Heneka

Shaw

Azzi

et al. 2018

Support Care Cancer

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This paper reports the findings of a priority setting process, undertaken with cancer and palliative care clinicians, to better understand the characteristics of medication errors with opioids within their services. Participants representing six public hospitals in one Australian state took part in a series of priority setting workshops and, drawing on actual incidents occurring in their services, sought to identify where in the opioid medication process errors were most frequently occurring. Opioid error types and perceived contributing factors were explored, and strategies to reduce/prevent opioid errors were proposed. The priority setting process provided valuable insights into the types of opioid errors that occur in cancer and palliative care services and the complexity of addressing opioid errors from the clinician's perspective. The findings from this priority setting process will inform future targeted quality improvement initiatives to support safe opioid medication practices in cancer and palliative care services.

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Examining Racial/Ethnic Differences in Patterns of Opioid Prescribing: Results from an Urban Safety-Net Healthcare System

Flores

Sharp

et al. 2023

J. Racial and Ethnic Health Disparities

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Prescription opioids still account for a large proportion of overdose deaths and contribute to opioid use dependence (OUD). Studies earlier in the epidemic suggest clinicians were less likely to prescribe opioids to racial/ethnic minorities. As OUDrelated deaths have increased disproportionately amongst minority populations, it is essential to understand racial/ethnic differences in opioid prescribing patterns to inform culturally sensitive mitigation efforts. The purpose of this study is to estimate racial/ethnic differences in opioid medication use among patients prescribed opioids. Using electronic health records and a retrospective cohort study design, we estimated multivariable hazard models and generalized linear models, assessing racial/ethnic differences in OUD diagnosis, number of opioid prescriptions, receiving only one opioid prescription, and receiving ≥18 opioid prescriptions. Study population (N=22,201) consisted of adult patients (≥18years), with ≥3 primary care visits (ensuring healthcare system linkage), ≥1 opioid prescription, who did not have an OUD diagnoses prior to the first opioid prescription during the 32-month study period. Relative to racial/ethnic minority patients, White patients, in both unadjusted and adjusted analyses, had a greater number of opioid prescriptions filled, a higher proportion received ≥18 opioid prescriptions, and a greater hazard of having an OUD diagnosis subsequent to receiving an opioid prescription (all groups p<0.001). Although opioid prescribing rates have declined nationally, our findings suggest White patients still experience a high volume of opioid prescriptions and greater risk of OUD diagnosis. Racial/ethnic minorities are less likely to receive follow-up pain medications, which may signal low care quality. Identifying provider bias in pain management of racial/ethnic minorities could inform interventions seeking balance between adequate pain treatment and risk of opioid misuse/abuse.

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Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study

Cited by 25 publications

References 54 publications

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

Clinicians’ perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report

Examining Racial/Ethnic Differences in Patterns of Opioid Prescribing: Results from an Urban Safety-Net Healthcare System

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