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Training school nurses in pain assessment benefits students with learning disabilities

Time and caseload reported as barriers to implementing change

Training school nurses in pain assessment benefits students with learning disabilities

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If not recognised and addressed, learning disabled students’ experiences of pain can cause absenteeism and reduce their ability to engage in and benefit from educational activities.

Unresolved pain can be expressed in idiosyncratic and atypical ways in people who have impairments of cognitive functioning and communication. It can be difficult to spot unless school nurses have relevant knowledge and skills.

This US study reported on the difference made by delivering a bespoke educational programme to 248 school nurses, which looked at good practice in assessing pain in children with learning disabilities. A range of pre- and post-training measures were used to determine changes in knowledge and use of pain assessment methods, and in the difficulties nurses reported with assessing pain.

Three-hour training sessions included consideration of the neurobiology of pain, pain as a psychosocial experience, a range of adapted pain assessment tools and methods, and atypical presentations of pain.

Following training, participants reported statistically significant reductions in difficulty experienced when undertaking pain assessments. Most participants also reported an intention to make wider changes to practice across their schools although, at follow-up, several noted that time and caseload constraints had acted as barriers to them implementing new approaches to pain assessment.

This paper supports the notion of learning disability practitioners working with school nurses to enhance their knowledge and skills in pain assessment for children with learning disabilities.

Quinn B, Smolinski M (2018) Improving school nurse pain assessment practices for students with intellectual disability. The Journal of School Nursing.  34, 6, 480-488.

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