Oncology Nursing Certification: Relation to Nurses’ Knowledge and Attitudes About Pain, Patient-Reported Pain Care Quality, and Pain Outcomes

Susan Beck

Jeannine M. Brant

Rebecca Donohue

Ellen M. Lavoie Smith

Gail Towsley

Patricia H. Berry

Jia-Wen Guo

Sharifa Al-Qaaydeh

Marjorie A. Pett

Gary Donaldson

pain, pain care quality, oncology, nurse certification, oncology nurses, pain attitudes and knowledge, outcomes
ONF 2016, 43(1), 67-76. DOI: 10.1188/16.ONF.67-76

Purpose/Objectives: To (a) compare pain knowledge and attitudes between nurses with oncology certified nurse (OCN®) status, non–OCN®-certified nurses, and nurses ineligible for certification and (b) examine the relationships among OCN® status, nurses’ knowledge and attitudes about pain, patient-reported quality of nursing pain care, and pain outcomes.

Design: Prospective, correlational survey design. Patients were nested within nurses.

Setting: Six inpatient oncology units in three hospitals: St. Vincent Healthcare in Billings, Montana; Norris Cotton Cancer Center at the Dartmouth–Hitchcock Medical Center in Lebanon, New Hampshire; and Huntsman Cancer Hospital in Salt Lake City, Utah.

Sample: 91 nurses in three states (28 OCN®-certified nurses, 37 noncertified nurses, and 26 not eligible for certification). Certification status was validated for 105 nurses who were matched with a sample of 320 patients.

Methods: Nurses completed a survey, and matched adult patients who were experiencing pain rated their pain care quality and pain experience during the past shift.

Main Research Variables: Demographic characteristics, certification status, and responses to the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), Pain Care Quality Survey–Nursing, and modified Brief Pain Inventory (Short Form).

Findings: OCN®-certified nurses scored significantly higher on the NKASRP (82% correct) compared to non-OCN® eligible nurses (76%) and non-OCN® ineligible nurses (74%) (p < 0.001). Only 43% overall achieved a benchmark of 80% correct. No statistically significant relationships existed between (a) certification status and pain care quality or pain outcomes or (b) NKASRP and care quality or outcomes (p > 0.05).

Conclusions: OCN®-certified nurses’ knowledge and attitudes related to pain management were superior to noncertified nurses. Neither knowledge and attitudes nor OCN® status were associated with pain care quality or pain outcomes.

Implications for Nursing: Knowledge is necessary but insufficient to improve patient outcomes; providing optimal pain care requires action. Sustained efforts to improve cancer pain management are indicated.

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