Study: E-learning Program for Nurses Could Improve Infant Pain Management


A new e-learning program could enable nurses to better evaluate and manage pain in neonates, according to investigators at Hiroshima University.

A flexible e-learning program may help to improve nurses’ knowledge and skills for better neonatal pain management after 4 weeks, according to investigators conducting research on the subject at Hiroshima University. However, the team of investigators was not able to conclude whether an e-learning program is superior to other training methods.

"Continuing education is essential to maintain and increase nurses' proficiency in neonatal pain assessment and treatment," said study lead Mio Ozawa, associate professor in the Graduate School of Biomedical and Health Science at Hiroshima University, in a press release.

Only recently did investigators discover that neonates, or newborns, experience pain like adults and children. However, they cannot express their level pain by pointing to a happy or sad face or using a numerical scale.

Ozawa explained that research has demonstrated that nurses are not currently trained in neonatal pain management, yet newborn intensive care unit (NICU) nurses have been shown to stay at the bedside of newborns for longer than other health care professionals to provide care.

This study was inspired by a previous one that analyzed the results of the e-learning program among 52 nurses. While their test scores generally improved during the training, there was no control group to show if the program was effective.

To expand beyond the limits of the first trial, this randomized control trial investigated the effects of e-learning for certified nurses to improve skills in newborn pain management across NICUs nationwide. Conducted in Japan, researchers performed the study by randomly dividing certified NICU nurses into 2 groups. One group participated in the e-Pain Management of Neonates program, which included 4 weeks of online training in pain measurement for pre-term newborns. During the 4 week program, the training consisted of 4 modules, each about 15 minutes long, which could be done any time, or any place. The other group received no training.

Before the first group began training, both groups took a pre-test. The researchers found that participants in both groups did not differ in knowledge or skills on neonatal pain management during the pre-test. After 4 weeks, both groups completed a post-test. The results of this final test showed that the group in the e-Learning 4-week program scored higher in both factors.

"Our results showed that e-learning programs were more effective as compared to no training,” Ozawa said in the press release.

However, although this study cannot accurately compare the efficacy of e-learning to in-person training, it showed that the program did improve knowledge and skill in neonatal pain management among NICUs.

"Learning in this program would allow nurses to acquire knowledge and skills concerning newborn pain, which is preferred over no education," Ozawa said in the press release. "Further research is needed to determine how nurses' training through e-learning programs is related to patient outcomes, such as more frequent pain assessment of infants by nurses and improved pain management."


How nurses learn to assess pain levels in infants. Hiroshima University; August 19, 2022. Accessed on August 23, 2022.

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