Professor Palliative Nursing

Wednesday, 1 August 2012

Jane L. Phillips, PhD
School of Nursing, The University of Notre Dame Australia, Darlinghurst, Australia
Louise Hickman, BN, RN, MPH, PhD
School of Nursing, University of Notre Dame, Broadway, Australia

Learning Objective 1: The learner will be able to identify the key elements of Spaced Education.

Learning Objective 2: The learner will be able to identify opportunites to apply Spaced Education to other clinical issues to promote best evidence based care.


Despite, treatment advances and pain being the fifth vital sign over a quarter of Australian palliative care patients' have reported having pain 'so severe' their activities or concentration were markedly affected. Addressing this unmet need is a clincial priority. 'Spaced Education’ is a novel form of on-line learning that has been shown to increase clinicans knowledge, retention of new knowledge whilst demonstrating a capacity to change entrenched clinical practice. This learning format may help improve nurse's pain assessment capabilities.


This study aims to increase specialist palliative care nurses’ pain assessment capabilities through ‘Spaced Education’ and decrease palliative care patients’ pain scores; and improve the level and quality of nurses’ pain assessment and reassessment documentation.


Study design and methods: Pre-post test quasi-experimental study design, with data collected at: baseline; post intervention; week 4; and week 16. The data collection tools include: Modified Nurses Knowledge and Attitudes Survey Regarding Pain; Prospective chart audits using a ‘Modified pain reassessment data tool’; and patient’s numerical rated pain score.

Study population: Australian specialist palliative care nurses.

Statistical analysis: The primary outcome measure is pain scores assessed on independent patient groups at different study time points. Pain scores will be compared across different time points using linear regression model with adjustment to patients’ and staff characteristics. ANOVA with repeated measurements will be applied to continuous variables and the McNemar’s test will be applied to categorical variables to assess the secondary outcome measures: changes in nurses’ knowledge/ attitude and pain assessment practices.

Conclusion: This pilot study provides an opportunity to test the impact of ‘Spaced Education’ as an education intervention on palliative care nurses’ pain assessment capabilities and patient reported pain. The data obtained will be used to power a larger study. If effective, Spaced Education offers the potential of contributing to incremental improvements in palliative care patient’s pain.