The Enduring Need for the Pain Resource Nurse (PRN) Training Program

Abstract

Nurses play a pivotal role in pain management but academic nursing curricula remain lacking in basic pain management principles. The purpose of this study was to evaluate the long-term impact of the City of Hope Pain Resource Nurse (PRN) Training Course on nursing pain management practice. An online survey, comparing RNs' pre- and post-training practice, assessed the long-term impact of the course on content application and dissemination. Participants with 1-9 years post-course attendance (2002-2010) were invited to complete a brief survey (N = 783). Respondents (N = 180; 23%) reported significant improvements in their comfort with basic opioid administration (p < .001). Relaxation was the most common non-drug intervention used by respondents. Pain assessment content was most frequently applied to practice (97%). Most respondents (89%) disseminated course content to others within their own institutions. PRN-trained nurses expressed improved confidence in pain management and attributed course content to the improvement in their practice behavior.

An Integrative Review of Pain Resource Nurse Programs

“…2,9,10,19 The most common form of PRN education is classroom style education with a lecturediscussion format, which can vary from a 2-day to 3-day program. 2 Program topics include pain assessment, pharmacological and nonpharmacological management, equianalgesic calculations, integrative approaches, enhanced communication, legal and ethical issues, psycho-spiritual aspects, managing pain for special populations, end-of-life pain management, and social/political advocacy.…”

“…9 One key program evaluation strategy includes assessment of participants' knowledge and attitudes using valid and reliable tools, such as Ferrell and McCaffery's Knowledge and Attitude Survey regarding Pain instrument. 2 Patients' satisfaction can be measured by widely used surveys such as Hospital Consumer Assessment of Healthcare Providers and Systems and Press Ganey.…”

“…Systems-based strategies utilize pain resource nurses (PRNs) as catalysts to optimize and improve nursing practice related to pain management. 9 A PRN is defined as "an RN who functions as both a resource and change agent in disseminating information, interfacing with nurses, physicians, other members of the health care team, patients and families to facilitate quality pain management." 10 Pain resource nurse programs have been established in acute care settings as systems-based programs to prepare and utilize PRNs who serve as pain management consultants in the care of patients with unresolved pain.…”

“…They developed a 40-hour didactic and clinical course to train a group of staff nurses to function as pain management experts for other staff nurses, serve as role models and change agents for the institution, and provide pain management education and consultation. 11 Three months after the program, the PRNs were evaluated and found to be more knowledgeable and have more positive attitudes and pain management behaviors than before the course. 11 In the past 20 years, different institutions have implemented similar programs and have expanded to several structural forms and processes of integration to clinical practice.…”

“…11 Three months after the program, the PRNs were evaluated and found to be more knowledgeable and have more positive attitudes and pain management behaviors than before the course. 11 In the past 20 years, different institutions have implemented similar programs and have expanded to several structural forms and processes of integration to clinical practice. 2,8,10,[12][13][14] While an abundance of evidence exists regarding pharmacological and nonpharmacological interventions for pain management, the 66 CRITICAL CARE NURSING QUARTERLY/JANUARY-MARCH 2016 evidence focusing on PRNs and/or PRN programs, specifically in acute care settings, has not been evaluated and remains unclear.…”