Congress Abstracts 2004

34

ADDRESSING NURSES’ PAIN MANAGEMENT COMPETENCY. June Eilers and Ann Berger, PhD, RN, OCN^®, University of Nebraska College of Nursing, Omaha, NE.

Staff competency is an essential component of optimum pain management in cancer care. Nurses’ potential to influence patient outcomes is restricted if they do not possess the necessary knowledge, skills, and abilities to intervene in a timely manner. As professionals, nurses have the responsibility to assure consumers that the nursing staff is competent to provide the care required by patients in the clinical setting.

Fulfilling this professional commitment and meeting the JCAHO requirement to “determine and ensure staff competency in pain assessment and management” are a challenge for healthcare institutions. Various approaches have been recommended for confirming competency, yet few have been implemented in this area of clinical practice. This presentation will review the process adapted to address competency and will report on two years of experience.

The pain management committee provided guidance for the process based on knowledge of patients’ rights, regulatory requirements, and common misconceptions and barriers to optimum pain management. The competency testing was implemented as part of annual competency testing. Educational packets to guide the nurses in their preparation for competency testing were made available to all nurses. They completed a monitored written test that examined multiple areas of competency. Individuals scoring below a predetermined cutoff were required to review content materials and retest. Nurses not passing the second time were expected to review additional educational content to expand their knowledge. Testing results from the first year guided the process for the second year.

Although no method of competency testing avoids all of the potential limitations, the process adopted has served to increase awareness of the importance of pain management, facilitated increased knowledge of misconceptions and barriers, and established competency in pain management as an expectation for nurses at our institution.

Oncology nurses frequently have experience caring for patients with varying types of pain and, thus, have the potential to advocate for improved pain management at their institutions. Through the promotion of competency testing, nurses can contribute to improved quality of care for individuals experiencing pain. Nurses in other centers can build on the two years of competency testing experience discussed in this presentation.