School of Nursing, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada (Dr Campbell-Yeo and Ms Carrier); MOM-LINC Lab, Centre for Pediatric Pain, IWK Health Centre, Halifax, Nova Scotia, Canada (Drs Campbell-Yeo and Kim); Rankin School of Nursing, Faculty of Science, St Francis Xavier University, Antigonish, Nova Scotia, Canada (Dr Benoit); Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning (PGCRL), Toronto, Ontario, Canada (Drs Bueno and Stevens and Mss Rao and Riahi); School of Kinesiology, The University of Western Ontario, London, Ontario, Canada (Ms Rao); and Lawrence S. Bloomberg Faculty of Nursing & Faculties of Medicine and Dentistry, University of Toronto, Ontario, Canada (Dr Stevens).
Adv Neonatal Care. 2022 Jun 1;22(3):246-252. doi: 10.1097/ANC.0000000000000922. Epub 2021 Jul 30.
Electronic health (e-health) learning is a potential avenue to educate health professionals about accurately using infant pain assessment tools, although little is known about the impact of e-health interventions on clinical competence.
To evaluate whether an e-health learning module for teaching the accurate use of the Premature Infant Pain Profile-Revised (PIPP-R) pain assessment tool results in immediate and sustained competency to assess infant pain.
Neonatal intensive care unit (NICU) nurses who participated in a larger study across 2 tertiary NICUs in Canada examining the implementation and clinical utility of the PIPP-R e-learning module completed 2 follow-up evaluations at 1 week and 3 months. Participants were asked to view a video recording of an infant undergoing a painful procedure and to assess the infant's pain intensity response using the PIPP-R measure. Immediate and sustained competency was assessed via interrater consensus of participant-reported PIPP-R scores compared with those of an experienced trained coder.
Of the 25 eligible nurses, 22 completed 1-week and 3-month follow-up evaluations. At the 1-week follow-up, 84% of nurses scored the video accurately compared with 50% at 3 months. Behavioral pain indicators were more likely to be scored incorrectly than physiological indicators.
Follow-up training after completion of the initial e-learning module training may improve competency related to the clinical use of the PIPP-R tool to assess infant pain over time.
Additional study regarding the need and timing of e-health training to optimize sustained competency in infant pain assessment is warranted.
电子健康（e-health）学习是向卫生专业人员传授准确使用婴儿疼痛评估工具的潜在途径，尽管人们对 e-health 干预措施对临床能力的影响知之甚少。
评估电子健康学习模块在教授准确使用早产儿疼痛评估工具修订版（PIPP-R）方面是否能立即和持续提高评估婴儿疼痛的能力。
参与了一项在加拿大 2 家三级新生儿重症监护病房（NICU）进行的更大规模研究的 NICU 护士，该研究考察了 PIPP-R 电子学习模块的实施和临床效用，他们在 1 周和 3 个月时完成了 2 次随访评估。参与者被要求观看一段婴儿接受疼痛程序的录像，并使用 PIPP-R 量表评估婴儿的疼痛强度反应。通过参与者报告的 PIPP-R 评分与经验丰富的训练有素的编码员评分的评分者间共识来评估即时和持续的能力。
在 25 名符合条件的护士中，有 22 名完成了 1 周和 3 个月的随访评估。在 1 周的随访中，84%的护士正确评估了视频，而 3 个月时只有 50%的护士正确评估。行为疼痛指标比生理指标更有可能被错误评分。
在初始电子学习模块培训完成后进行跟进培训，可能会随着时间的推移提高与临床使用 PIPP-R 工具评估婴儿疼痛相关的能力。
需要进一步研究电子健康培训的必要性和时机，以优化婴儿疼痛评估的持续能力。
