Educating registered nurses in pain knowledge and documentation management

ISRCTN ISRCTN81992130
DOI https://doi.org/10.1186/ISRCTN81992130
Submission date
05/06/2020
Registration date
18/06/2020
Last edited
06/10/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Registered nurses (RNs) play a vital role in patients' pain management after surgery. Therefore, it is important for RNs to have adequate knowledge and documentation skills when it comes to postoperative pain care. The aim of this study is to develop and test a brief educational intervention based on Finnish acute postoperative pain nursing practice guidelines, in order to improve RNs’ knowledge of pain management and improve their postoperative documentation skills.

Who can participate?
Registered nurses (RNs) at a central hospital in Finland

What does the study involve?
RNs are randomly allocated to the intervention and control groups the day before the beginning of the intervention. All participants take the Acute Postoperative Pain Knowledge Test©. Once all participants respond to the test, the researcher calls out the names of individuals who are to leave the classroom and conduct the tests with the remaining nurses. The RNs who leave the classroom become members of the control group, and those who remain in the classroom belong to the intervention group. Only the intervention group RNs participate in the education intervention. The intervention lecture starts immediately after the control group leave the room. After the lecture, the intervention group again take the Acute Postoperative Pain Knowledge Test©. Three months after the intervention, the researcher directly conducts the retention test, personally asking the RNs to take the same test again. The researcher audits each RN's pain documentation from three different patient records before and after the intervention and after 3 months.

What are the possible benefits and risks of participating?
Half of the participating RNs receive a brief postoperative pain education. There are no risks of participating.

Where is the study run from?
Central Finland Health Care District (Central Finland Central Hospital)

When is the study starting and how long is it expected to run for?
October 2016 to July 2018

Who is funding the study?
Finnish Vascular Nursing Society (Suomen Verisuonihoitajayhdistys)

Who is the main contact?
Salla Grommi
sallagro@uef.fi

Contact information

Miss Salla Grommi
Scientific

University of Eastern Finland, Department of Nursing Science
Yliopistonranta 1 C
Kuopio
70211
Finland

ORCiD logoORCID ID 0000-0003-1448-5099
Phone +358 (0)505358453 or +358 (0)503017339
Email sallagro@uef.fi

Study information

Study designRandomized controlled trial with a pre-, post-, and retention-tests design
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeOther
Participant information sheet Not available in web format please use contact details to request a participant information sheet
Scientific titleEducating registered nurses in pain knowledge and documentation management: a randomized controlled trial
Study objectivesH0: μc = μi and H1: μc < μi, where μc is the average change in RNs’ pain knowledge or documentation quality in the control group and μi is the average change in RNs’ pain knowledge or documentation quality in the intervention group. The threshold for statistical significance (p) is <0.05.

Alternatively, the hypothesis could be formulated as follows: H0: d ≤0.2 and H1: d >0.2, where d is 𝜇𝜇𝑖𝑖−𝜎𝜎𝜇𝜇𝑐𝑐 (Cohen 1988). In d, μi is the average change in RNs’ knowledge or documentation quality in the intervention group, μc is the average change in RNs’ knowledge or documentation quality in the control group, and σ is the combined standard deviation.
Ethics approval(s)This type of study does not require ethics approval in Finland, the target organization's study protocol and permission to start study are enough. The volunteers were informed about the purpose of the study and voluntary participation, and their written informed consent was taken.
Health condition(s) or problem(s) studiedRNs' postoperative pain knowledge and documentation
InterventionIn this study, RNs work in three selected surgical wards. Before the study, the researchers coordinate with the units’ nursing managers in order to bring the RNs to the training space. The RNs’ shifts are planned to begin and end earlier or later. Only the research team and nurse managers know the exact date of the intervention. On the previous day, the researcher (first author) allocates the RNs to groups (surgical ward 1, surgical ward 2, surgical ward 3 and vice staff personnel); then those four groups again are randomly placed into two groups (intervention and control groups). The participants are unaware of the allocation until the intervention.

The researchers implement the study on a single day in April 2017 between 12 am and 16 pm. On that day, all of the nursing staff working on the morning or evening shifts constitute the study population (N=50). On the intervention day, the evening shift RNs come to the training space at 12 am. The researcher first tell RNs about the research. If the RNs fill in the consent form, they agree to participate in the study. Second, all participants take the Acute Postoperative Pain Knowledge Test©. Once all participants respond to the test, the researcher calls out the names of individuals who are to leave the classroom and conduct the tests with the remaining nurses. The RNs who leave the classroom become members of the control group, and those who remained in the classroom belong to the intervention group. Only the intervention group RNs participate in the education intervention. The intervention lecture starts immediately after the control group left the room. After the lecture, the intervention group again take the Acute Postoperative Pain Knowledge Test©. After the intervention group take the test again, they go to their units to be relieved by the morning shift. Morning shift RNs come to the classroom at approximately 14 pm. The previous protocol is repeated in exactly the same manner. However, after the protocol, all morning-shifts RNs finish their workdays. This design aims to control the potential impact of the interaction between the intervention and control groups.

Three months after the intervention, the researcher directly conducts the retention test in work units, personally asking RNs to take the same test again. Tests are taken under the supervision of the researcher. A documentation audit is conducted retrospectively in spring and summer 2018. The researcher audit each RN’s documentation from three different patient records three times at the baseline, post and retention stages.
Intervention typeBehavioural
Primary outcome measurePain knowledge measured using the Acute Postoperative Pain Knowledge Test© pre-intervention, post-intervention, and at 3 months
Secondary outcome measuresPain documentation assessed using documentation audit pre-intervention, post-intervention, and at 3 months
Overall study start date01/10/2016
Completion date31/07/2018

Eligibility

Participant type(s)Health professional
Age groupAdult
SexBoth
Target number of participants50
Total final enrolment50
Key inclusion criteriaThe researchers implemented the study on a single day in April 2017 between 12 am and 16 pm. On that day, all of the nursing staff working on the morning or evening shifts constituted the study population (N=50) in three surgical wards.
Key exclusion criteriaNot working in the intervention day in three selected surgical wards, other profession than RN
Date of first enrolment18/04/2017
Date of final enrolment31/07/2017

Locations

Countries of recruitment

  • Finland

Study participating centre

Central Finland Health Care District
Keskussairaalantie 19
Jyväskylä
40620
Finland

Sponsor information

University of Eastern Finland
University/education

Department of Nursing Science
Itä-Suomen yliopisto
Hoitotieteen laitos
PL 1627
Kuopio
70211
Finland

Phone +358 (0)403552629
Email hannele.turunen@uef.fi
Website http://www.uef.fi/en
ROR logo "ROR" https://ror.org/00cyydd11

Funders

Funder type

Other

Finnish Vascular Nursing Society (Suomen Verisuonihoitajayhdistys)

No information available

Results and Publications

Intention to publish date08/12/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planPlanned publication immediately after registration.
IPD sharing planThe datasets analyzed during this study will be included in the subsequent results publication.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 01/05/2021 06/10/2022 Yes No

Editorial Notes

06/10/2022: Publication reference added.
15/06/2020: Trial's existence confirmed by Central Finland Health Care District.