Pediatric Postoperative Pain Management in Surgical Wards - an Intervention Study

Study Overview
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Brief Summary
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This study will explore healthcare providers' pediatric postoperative pain management knowledge and clinical practice. The aim of this study is to explore healthcare providers' knowledge and clinical practice in pediatric postoperative pain management in surgical wards, and to evaluate whether an educational intervention would improve postoperative pain management. This study has a pre-post intervention design. This study will be conducted on four surgical wards in one university hospital in Norway. There will be used different methodological approaches for data collections (interviews, questionnaire, observational study) with four measurement points; baseline (T1), and one month (T2), six months (T3) and 12 months (T4) after intervention.

Detailed Description
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This study will be conducted on four surgical wards in one university hospital in Norway. There will be used different methodological approaches for data collections (interviews, questionnaire, observational study) with four measurement points; baseline (T1), and one month (T2), six months (T3) and 12 months (T4) after intervention. To get a broader view of barriers and facilitators for effective pediatric postoperative pain management, there will be carried out focus group interviews with healthcare providers. Further, data about healthcare providers' knowledge and attitudes regarding pediatric pain will be collected using a questionnaire. Data about nurses' pediatric postoperative pain management will be collected using non-participant observational study and data about children's experience about pain and pain management will be collected using face-to-face interviews with children. This study will have different phases: Phase 1 Explore healthcare providers' knowledge, clinical practice children's experiences of pain and pain management, and healthcare providers' experiences of barriers and facilitators for effective pain management Questionnaire PNKAS-N Observation of clinical practice Face-to-face interviews with children Focus group interviews with healthcare providers (barriers and facilitators) Phase 2 Develop and implement a tailored educational intervention Develop tailored educational intervention based on: Available research Results from baseline Feedback from head of the relevant units Staff views about the facilitators and barriers to optimized pediatric pain management Implementation of the intervention Seminar (lecture and workshop) Clinical supervision Reminders Phase 3 Evaluation of the intervention Questionnaire PNKAS-N Observation of clinical practice

Official Title
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Pediatric Postoperative Pain Management in Surgical Wards - an Intervention Study

Conditions
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Postoperative Pain

Intervention / Treatment
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* Other: Tailored educational intervention


Participation Criteria
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Eligibility Criteria
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Questionnaire Inclusion Criteria: nurses working at all four wards and all surgeons (experienced) at the corresponding wards Exclusion Criteria: nurses not involved in clinical work Observational study Inclusion Criteria: nurses working in all four wards children (0-18 years) admitted to these wards during the data collection period, and their parents Interview with children Inclusion Criteria: children (6-18 years) going through surgery at all four wards during the data collection period, and their parents Exclusion Criteria: children with cognitive impairment who were unable to communicate verbally children who did not speak Norwegian children younger than six years Interview with healthcare providers Inclusion Criteria: healthcare providers working in the four wards (two to four nurses, two surgeons, and two anesthesiologists in each group)
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tailored educational intervention<br>The intervention will be based on previous research and results from baseline (T1). The intervention will be a one-day educational day and includes lectures and workshops with main focus on the lowest competence in pediatric postoperative pain management. Healthcare providers at the included surgical wards will be invited to participate on this educational day. As a supplement, there will be provided clinical supervision in pediatric postoperative pain management and reminders (such as lectures and posters) over a period of six months after educational day. | Other: Tailored educational intervention<br>* Educational day (lecture and workshop), clinical supervision and reminders<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Healthcare providers' knowledge and attitudes of pediatric pain management | Evaluated with The Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain Questionnaire - Norwegian version (PNKAS-N).The questionnaire consists of 36 questions with a total score of 36. The scale ranges from minimum 0 to maximum 36 (best score). | Baseline | 
| Changes in Healthcare providers' knowledge and attitudes of pediatric pain management | Evaluated with The Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain Questionnaire - Norwegian version (PNKAS-N). The questionnaire consists of 36 questions with a total score of 36. The scale ranges from minimum 0 to maximum 36 (best score). | short term - one month after intervention and long term - six and 12 months after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nurses' pediatric postoperative pain management practices in surgical wards | Evaluated with non-participant observation using a structured observational tool (checklist) and field notes | Baseline | 
| Changes in nurses' pediatric postoperative pain management practices in surgical wards | Evaluated with non-participant observation using a structured observational tool (checklist) and field notes | short term - one month after intervention and long term - six and 12 months after intervention | 
| Children's experiences of pain and pain management after surgery | Evaluated using semi-structured face-to-face interviews with children after surgery | Baseline | 
| Healthcare providers experience barriers and facilitators for effective pediatric postoperative pain management | Evaluated using semi-structured focus group interviews with healthcare providers | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain management, pediatric pain, postoperative pain, pain assessment, healthcare providers, children, nurses, physicians, tailored educational intervention, surgical wards