E-poster Presentation 2014 World Cancer Congress

Multi-centre pre-post test trial of a complex Qstream© pain assessment intervention on cancer nurses’ pain screening and assessment practices (#1035)

Jane L Phillips 1 , Nicole Heneka 1 , Lawrence T Lam 2 , Tim Shaw 3
  1. Cunningham Center for Palliative Care & University of Notre Dame Australia, Darlinghurst , NSW, Australia
  2. Department of Health and Physical Education , The Hong Kong Institute of Education, Hong Kong SAR, , CHINA
  3. Director, Postgraduate Nursing Studies, Faculty of Health, University of Technology, Sydney , NSW, AUSTRALIA


Despite, international and national cancer pain guidelines recommending routine screening and comprehensive assessment as crucial components of better pain management, people living with cancer often experience undetected and undertreated pain. This project utilised a novel online performance feedback intervention to address this clinical gap.


To measure the impact of a tailored Qstream© cancer pain assessment performance feedback intervention on inpatient cancer nurses’: i) pain assessment capabilities; and ii) adherence to cancer pain screening and assessment guideline recommendations.


Setting: Specialist inpatient cancer nurses in five acute care settings within one translational cancer research network in NSW, Australia.
Study design: Pre-post test prospective follow-up study.
Methods: Survey and chart audit data collected: pre (T1) and post (T2-T3) intervention, and final chart audit 4 weeks (T4) post audit and feedback.
Intervention: Participants completed 11 case based  pain assessment scenarios delivered to their nominated email via Qstream before the T1-T2 pain assessment chart audit data was feedback to them at T3.


Intervention participants (n=44) increased their pain assessment knowledge, pain assessment tool knowledge and confidence to undertake a pain assessment (p<0.001), which was maintained at 10 weeks post-intervention. The positive changes in nurses’ pain assessment capabilities’ translated into a significant increasing linear trend in the proportion of documented pain assessments in patients’ charts at three time points (χ2 trend =18.28, df=1, p<0.001). The median pain assessment documentation quality scores also increased during the study period (Kruskal- Wallis test χ21 =7.17, p=0.007).


Integrating specialised on-line clinical content and audit and feedback into a QStream© module improves nurses’ pain assessment practices. The next step is to confirm these results in an adequately powered randomised controlled trial.