| Description |
This project examined the utility of an educational module to increase the knowledge and understanding of the application of current clinical guidelines by a health care team (HCT) in the assessment of pain in older adults with cognitive dysfunction. Twelve members of the HCT in a local memory care facility were educated on the use of a validated pain assessment tool in cognitively impaired older adults, and knowledge gain was evaluated. The primary problem addressed was the inability to be assured that pain is adequately assessed in older adults with impaired cognition, as cognitive disorders that result in communication impairments often complicate pain assessment. The objectives of this project were to, 1) develop and deliver an educational module to improve HCT knowledge and use of a pain assessment tool in older adults with cognitive dysfunction, 2) implement and evaluate the educational module that instructs the HCT to better assess pain in their older adult population, and 3) disseminate the outcomes of this project in a peer-reviewed forum by professional poster presentation and submission of an abstract to a professional organization. Review of the literature revealed that chronic pain affects half of persons over 65 years of age, and those with dementia are similarly afflicted. More than 80% of residents in long-term care facilities live with chronic, daily pain. Older adults with cognitive and communication disorders are completely dependent on the expertise of their HCT to recognize, assess, and treat their pain. Failure to treat pain may lead to severe morbidity and mortality, including the circular sequelae of pain, depression, and declining cognition. Implementation was instituted through development of an educational module, a pre- and post-test, and a 4-week follow-up survey to evaluate the facility's continued use of the assessment tool. The educational module, pre and post-tests were administered to the HCT. Due to delays within the Institutional Review Board, the 4-week follow up survey was not completed. Descriptive statistics of the sample and measures were summarized, and paired t-test was performed to determine the change in knowledge from pre to post-test. A total of 12 clinicians were educated with the majority female (75%) and Caucasian (67%), and aged 40 (+ 16.71) years. There were a variety of educational levels and job categories: MD (n=1), PA (n=1), BSN (1), 2-year RN (2), LPN 1, CNAs (4), HS (4). The mean pain assessment pre-test score was 6.53 (+ 3.54) and the mean post-test score was 9.67 (+ 2.55) on a 15-point scale. This resulted in a p-value of <0.001 indicating a statistically significant increase in knowledge on the pain assessment questionnaire from pre to post test. This project revealed that education for those who care for older adults with cognitive dysfunction is effective in improving pain assessment knowledge, potentially allowing for improved care. Future study is needed to assess the adoption of regular pain assessment using a pain tool and if quality of care is improved at this facility. |
