A stepping stone approach to managing pain

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You can always smell when the spring season is upon us. With this season comes the feeling of hope and anticipation of what good things lay ahead. For the employees and partners of SCO Health Service this hope also comes in the form of a new and innovative pain management tool which will assist in providing high quality care to their patients, residents, and clients.

SCO Health Service (SCOHS) in Ottawa has a strong history in Canadian health-care and a commitment to being a champion of well-being for aging Canadians and those requiring continuing care, helping them become and remain as healthy and independent as possible through innovative and compassionate care, research, education and advocacy. This 753-bed organization has four core programs: care of the elderly and rehabilitation, complex continuing care, long-term care and a palliative care program which provides comprehensive access to inpatient and outpatient services. The mission of the palliative care program is to promote quality of life for patients experiencing a life threatening illness. There is a direct link to quality of life and relief of symptoms. An innovative pain management educational program from the Regional Palliative Care Community Services program at the Élisabeth Bruyère Health Centre site is evidence of this commitment.

Uncontrolled pain has long been known to increase psychological distress and can increase the risk of depression, anxiety and delirium. The principles of pain assessment and management can be utilized no matter what the age of the person experiencing the pain. One in five people (21 per cent) experience pain most days or every day; the number of people in pain increases with age: nearly one in three (32 per cent) of the over-65 population are in pain at least most days.

This crisis in health care challenges health-care professionals and education experts to explore new and innovative ways to provide much needed education programs that will enhance knowledge and upgrade skills to ultimately meet the care and treatment demands of Canadians. Change is not readily embraced in a traditional industry like health care. We have relied on class room based teaching for far too long. Now that research has proven e-learning as an equally effective method we have to support our learners in their adoption of technology.

Building on the success in the private sectors, SCOHS is developing an e-learning program entitled, “Managing Pain Together.” The theme of “stepping stones along a river” was chosen as the visual element as it takes the learner along a pathway towards better pain management. This e-learning program will be comprised of five modules or stepping stones:

1. Understanding and Recognizing Pain (the present module)

2. How to Conduct a Thorough Pain Assessment (planning underway)

3. Pain Assessment in the Cognitively Impaired Population

4. Pain Management

5. Evaluating Your Pain Assessment and Management Interventions

Each stepping stone has been developed to minimize the time staff need to be away from the bedside. A ‘family feud’ type of game has been included to provide interaction and interest in learning and the program uses a case-based approach with integrated audio and video clips.

A team of palliative care clinicians, education specialists, an instructional designer, a graphic designer and information systems experts all worked collaboratively to develop this project. The first module will be available to SCOHS Service partners in June 2008. “In the past, we used to send our staff to outside conferences for learning opportunities, but we realized that those events were often not tailored to our needs and that there was limited knowledge transfer,” says Margaret Lerhe, director of learning, SCOHS. “Now, we directly respond to the needs of our staff. And we also make these learning opportunities accessible to the whole Champlain region; hence the creation of this new e-learning tool.”

The learner’s demands for quality content, delivery, and service will be met if they can easily access and navigate the technological environment. Faculty will be able to construct a pedagogical strategy that ensures feedback, engages learners in problem-solving experiences, reinforces critical thinking, and provides reinforcement.

Administration will be able to monitor learner outcomes including: learner satisfaction, acquisition of new and relevant skills and knowledge, application of new knowledge in the workplace, and overall impact of learning on patient care.

According to the Canadian Centre for Occupational Health and Safety, taking an e-learning program typically requires 30-60 per cent less time than attending a comparable classroom course. Because of this project, future patients and residents of SCOHS and partners will be cared for by health-care providers with an increased knowledge in pain management – a step in the right direction.

With the stepping stones program, health-care providers from within the Champlain region will have access to a convenient, flexible, and cost-effective means of pain management education that supports a diverse range of clinical learners. Learners will be able to access a range of educational resources in an active and dynamic learning environment where they can engage in learning opportunities that create a personally meaningful experience.