Impact of a pain management education intervention for prehospital care providers

Background & Introduction: Under-treatment of pain in the prehospital setting is a common occurrence [1]. Routine clinical audit identified an inadequate level of analgesia administration to medical and trauma patients reporting pain on a Numeric Rating Scale (NRS; 0-10 scale). Anecdotal evidence from informal discussion with clinical staff revealed this was primarily due to an education gap existing. We sought to address this clinical deficiency through a proven method of a targeted educational intervention (EI). [2, 3] Methods: Thirty clinical staff participated in an eight-hour pain management EI facilitated by two experienced Clinical Educators. Pre- and post-course surveys were provided to participants. Participation was anonymous and voluntary. The EI consisted of didactic lectures addressing the physiological response to pain, pharmacological and non-pharmacological analgesia options, documentation of analgesia and scenario-based simulated clinical cases requiring application of clinical knowledge to patient care. Results: Post-EI, participants reported their understanding of the physiological process of pain as having improved. Participants also declared an improved knowledge of pharmacological and non-pharmacological pain relief options. Ability to calculate medication dosages was also reported as improved. Subsequent clinical audit displayed an improved level of appropriate analgesia administration to patients reporting pain as per NRS in the one-month period following the EI. Conclusion: A targeted EI addressing deficiencies identified by a rigorous clinical audit process resulted in improved baseline knowledge, improved psychomotor skills, and subsequent improved clinical management of pain. These results suggest both initial and ongoing continuing education addressing pain management is of benefit to prehospital care providers.