Implementation of a multidimensional pain competency education program for neonatal healthcare professionals to translate pain knowledge into clinical practice: A mixed methods study

Abstract

Background: Undertreatment of neonatal pain is often attributed to inadequate healthcare professional education. Determining strategies to effectively improve clinical pain knowledge to promote the skills and practices of neonatal healthcare professionals is imperative. Objectives: To develop a multidimensional pain competency education program and to evaluate its effect on neonatal healthcare professionals' pain management knowledge, attitude, self-efficacy, behaviors, as well as on neonatology department's pain management practice. Design: A mixed-methods design. Participants: A total of 110 neonatal healthcare professionals (24 physicians, 86 nurses) attended the education program, and 44 (8 physicians, 36 nurses) completed the follow-up survey. Methods: A multidimensional pain competency education program was developed and implemented as a two-day training course, followed by three-month online support comprising two thematic workshops and ongoing practice-based support. Followed Kirkpatrick's model, the training effects were evaluated using quantitative and qualitative data collected at baseline (T1), after the two-day training course (T2), and after completing the education program (T3). Results: Neonatal healthcare professionals rated their education program satisfaction at 2.75 out of 3, indicating positive reaction-level evaluation in Kirkpatrick's model. At the learning level, their scores in pain management knowledge, attitude, and self-efficacy were significantly higher at both T2 and T3 compared to baseline (T1) (P < 0.05). At behavior level, significantly more participants used topical analgesics and non-pharmacological interventions to prevent and relieve pain at T3 compared to those at T1 (P < 0.05). At results level, a significantly higher number of key liaison neonatology departments have used or plan to use a neonatal pain assessment scale, have established or plan to establish a protocol for neonatal procedural pain assessment and management (P < 0.05). Two themes (Gain from learning and Training feedback) and eight sub-themes were identified from reflection writing about their experience of this education program. Conclusion: The multidimensional pain competency education program for neonatal healthcare professionals can improve the level of pain management knowledge, attitude, self-efficacy and behaviors of neonatal healthcare professionals, and promote the change of pain management practice in the neonatology department.