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The impact of an educational module on pre-hospital providers’ knowledge in pediatric pain physiology, assessment, and management

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Abstract:

Emergency Medical Service providers (EMSP) frequently transport children with painful conditions to emergency departments (ED). Despite the availability of analgesic agents to EMSP, most children do not receive analgesia. Studies identified inability to assess pain and lack of knowledge on pediatric pain management as potential barriers to adequate pain management.
Hypothesis: A prehospital educational program will improve EMSP pain assessment and management in children 5-17 years of age with isolated extremity trauma (ET) or burns (BU).
Methods: In phase one of the study EMSP documentation of pain assessment and management for eligible patients audited. ED records for these patients were reviewed for admission pain score, diagnosis, and intervention. An educational module with power point presentation and an audio was developed focused on pain physiology, pain assessment, and pharmacological and non-pharmacological pain management techniques in children. A multiple choice examination keyed to presentation topics was developed. The module and exam were posted on the county EMS web site. Prehospital providers logged onto a secured link took the exam (pre), reviewed the presentation, and then completed the posttest. Monitoring the providers practice and reviewing hospital records continued throughout this phase of the project.
Results: During a 14 months pre educational intervention period 134 eligible patients were transported, 127 with ET and 7 BU. Pain assessment was documented in 19 patients (14%) but only 4% (5/127) of patients with ET and 57% (4/7) with BU had documentation regarding morphine administration by EMSP. In the two months post the educational module 19 patients were transported, 18 with ET and 1 BU. Morphine was administered to 20% (3/18) with ET and 100% with BU. The pretest and post test were taken by 215 EMSP. On the pretest 28% passed with a score of 75% or greater and on the posttest 86% passed. The test reliability score was .86
Conclusion: Our preliminary result indicates that an on-line, narrated PowerPoint based educational module for prehospital providers improved pain management in children with ET or BU. However, there was no significant improvement in documentation of pain assessment providing an opportunity for further study.
Supported by HRSA/EMSC grant #H34-MC02548-01
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Association:
Name: National Association of EMS Physicians
URL:
http://www.naemsp.org


Citation:
URL: http://citation.allacademic.com/meta/p64890_index.html
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MLA Citation:

Hennes, Halim., Rehm, Judi., Sternig, Ken., Pirrallo, Ronald. and Kim, Michael. "The impact of an educational module on pre-hospital providers’ knowledge in pediatric pain physiology, assessment, and management" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL, <Not Available>. 2013-12-17 <http://citation.allacademic.com/meta/p64890_index.html>

APA Citation:

Hennes, H. , Rehm, J. , Sternig, K. , Pirrallo, R. and Kim, M. "The impact of an educational module on pre-hospital providers’ knowledge in pediatric pain physiology, assessment, and management" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL <Not Available>. 2013-12-17 from http://citation.allacademic.com/meta/p64890_index.html

Publication Type: Abstract
Abstract: Emergency Medical Service providers (EMSP) frequently transport children with painful conditions to emergency departments (ED). Despite the availability of analgesic agents to EMSP, most children do not receive analgesia. Studies identified inability to assess pain and lack of knowledge on pediatric pain management as potential barriers to adequate pain management.
Hypothesis: A prehospital educational program will improve EMSP pain assessment and management in children 5-17 years of age with isolated extremity trauma (ET) or burns (BU).
Methods: In phase one of the study EMSP documentation of pain assessment and management for eligible patients audited. ED records for these patients were reviewed for admission pain score, diagnosis, and intervention. An educational module with power point presentation and an audio was developed focused on pain physiology, pain assessment, and pharmacological and non-pharmacological pain management techniques in children. A multiple choice examination keyed to presentation topics was developed. The module and exam were posted on the county EMS web site. Prehospital providers logged onto a secured link took the exam (pre), reviewed the presentation, and then completed the posttest. Monitoring the providers practice and reviewing hospital records continued throughout this phase of the project.
Results: During a 14 months pre educational intervention period 134 eligible patients were transported, 127 with ET and 7 BU. Pain assessment was documented in 19 patients (14%) but only 4% (5/127) of patients with ET and 57% (4/7) with BU had documentation regarding morphine administration by EMSP. In the two months post the educational module 19 patients were transported, 18 with ET and 1 BU. Morphine was administered to 20% (3/18) with ET and 100% with BU. The pretest and post test were taken by 215 EMSP. On the pretest 28% passed with a score of 75% or greater and on the posttest 86% passed. The test reliability score was .86
Conclusion: Our preliminary result indicates that an on-line, narrated PowerPoint based educational module for prehospital providers improved pain management in children with ET or BU. However, there was no significant improvement in documentation of pain assessment providing an opportunity for further study.
Supported by HRSA/EMSC grant #H34-MC02548-01

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