title: Pain Assessment and Management After a Knowledge Translation Booster Intervention.
abstract: Inadequate pain treatment leaves hospitalized children vulnerable to immediate and long-term sequelae. A multidimensional knowledge translation intervention (ie, the Evidence-based Practice for Improving Quality [EPIQ]) improved pain assessment, management, and intensity outcomes in 16 units at 8 Canadian pediatric hospitals. The sustained effectiveness of EPIQ over time is unknown, however. The goals of this study were to determine the following: (1) sustainability of the impact of EPIQ on pain assessment, management, and intensity outcomes 12, 24, and 36 months after EPIQ; (2) effectiveness of a pain practice change booster (Booster) intervention to sustain EPIQ outcomes over time; and (3) influence of context on sustainability.
  
  
  
  A prospective, repeated measures, cluster randomized controlled trial was undertaken in the 16 EPIQ units, 12 months after EPIQ completion, to determine the effectiveness of a practice change booster (Booster) to sustain EPIQ outcomes. Generalized estimating equation models examined outcomes controlling for child and unit contextual factors.
  
  
  
  Outcomes achieved during EPIQ were sustained in the use of any pain assessment measure (P = .01) and a validated pain assessment measure in the EPIQ units (P = .02) up to 36 months after EPIQ. Statistically significant improvements in pain management practices persisted in EPIQ units; results varied across time. There were no significant differences in outcomes after implementation of the Booster between the Booster and Nonbooster groups.
  
  
  
  Improved pain assessment and management practices were sustained after EPIQ; however, the Booster did not seem to provide additional impact.
authors: Research Institute and bonnie.stevens@sickkids.ca.|Lawrence S. Bloomberg Faculty of Nursing, Faculties of Dentistry and Medicine.|University of Toronto Centre for the Study of Pain.
authors: Bonnie J
authors: BJ
authors: Stevens
authors: Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada.
authors: Janet
authors: J
authors: Yamada
authors: Research Institute and.|University of Toronto Centre for the Study of Pain.
authors: Sara
authors: S
authors: Promislow
authors: Research Institute and.|Department of Psychiatry, Dalla Lana School of Public Health, and.
authors: Melanie
authors: M
authors: Barwick
authors: Quality Management Department, The Hospital for Sick Children, Toronto, Ontario, Canada.|Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada; and.
authors: Marie
authors: M
authors: Pinard
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D055317:Evidence-Based Practice / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D058996:Quality Improvement; D057170:Translational Research, Biomedical