Development And Implementation Of A Training Course For Clinical Nurse Specialist In Pain Management Based On Core Competencies

BackgroundTraining clinical nurse specialist in pain management is urgent because pain management of patient is still insufficient,and nurses lack knowledge of pain management.The interprofessional consensus summit for core competencies in pain management provides a basis to improve the quality of pain education,including four pain management core competencies aspects:multidimensional nature of pain,pain assessment and measurement,management of pain,and clinical conditions.There are research on knowledge,clinical practice teaching and evaluation index system based competencies for clinical nurse specialist training in pain management in China.However,there is no training for that applies the above core competencies in pain management.ObjectivesTo develop a training course based on core competencies for clinical nurse specialist in pain management,and evaluate nurses’ pain knowledge,practice ability and satisfaction after the training.Methods1.The course developmentPreliminary development of a training course was based on the interprofessional consensus summit for core competencies in pain management including the above four pain management core competencies aspects,and adding—professional development of clinical nurse specialist in pain management.The course was determined by two-round Delphi method.2.The course implementationThe trainees who participated in the first training for training clinical nurse specialist in pain management held by Guangdong Nursing Association from October to December in 2019 were selected.Fifty nurses from 40 hospitals in seven provinces attended the three-month training with didactic content teaching and practice.In the first eight weeks,didactic content teaching and practice were carried out alternatetively,and in the last four weeks,trainees practiced in one to two departments of the clinical practice training bases.Using Knowledge and Attitude Survey Regarding Pain(KASRP)(scored 0-41)to evaluate the change for knowledge and attitude regarding pain of trainees before and after the training.Using Clinical Pain Knowledge Test(CPKT)(scored 0-23)to evaluate the change for pain management core competencies of trainees before and after the training.Paper and practice examination were completed and trainees’ satisfaction was surveyed.Results1.Results of two-round Delphi method for the courseSixteen experts attended the two-round Delphi consultation.The authority coefficient of two-round Delphi method were 0.916 and 0.910,respectively.The positive coefficient of experts in the two rounds were 1.000 and 0.940,respectively,and the Kendall’s coefficient of concordance were 0.197and 0.250,respectively(both P<0.01).The 508-hour training course covers five aspects including multidimensional nature of pain,pain assessment and measurement,management of pain,and clinical conditions,and pain specialty construction and professional development.2.Trainees’ pain knowledge level before and after the training.After the training,the trainees’ average correct rate of the KASRP and the CPKT increased from 57.54%to 70.98%,and from 52.53%to 66.19%,respectively.The score of the KASRP and the CPKT increased from(23.59 ± 4.28)to(29.10 ± 3.86)(t=-9.482,P<0.01),and from(12.08± 2.53)to(15.22 ± 2.02)(t=-6.986,P<0.01),respectively.3.Nurses’ pain practice ability and satisfaction after the trainingUpon completion,the average score of the practice examination was(89.81 ±2.30).The trainees were satisfied with the training,with scores of the degree of course learning requirement met,satisfaction with teaching and practice all over 4 points.ConclusionsThe training course for nurse specialists based on core competencies is scientific and reasonable,which could improve trainees’ level of pain knowledge and competencies.