1. Health Promoting Hospitals Veneto Region Network Pain Free Hospitals: The educational training of the HPH Veneto Region Network Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPHs Dublin, May 18-20 2005 Sabrina Marconato M.D. University of Padua (Italy)

2. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 2 NORTH- EAST OF ITALY 4.5 MILLIONS OF INHABITANTS MAIN TOWN VENICE 18,364 Km 2 Veneto Region

3. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 3 Veneto Territory is divided in : Veneto Regional Health System 22 Health Social Local Trusts (HSLT) Each HSLT 2-3 Hospitals 1 General Director Territorial Sanitary and Social Services

4. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 4 6 Health Social Local Trusts (HSLT) STARTED IN 2002 FOR PREPARING THIS HPH PAIN FREE TRAINING Hospitals + their Territory Health Services

5. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 5 WHY EDUCATIONAL TRAINING ?

6. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 6 A POLYCENTRIC SURVEY IN 11 HOSPITALS SHOWED

7. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 7 % Distribution of the percentage of pain Perceived by patients 48% (594) 20% (242) 10% (128) 22% (270) absent mild moder. severe 1325 INPATIENTS 52 % pain (IC 95% 49-55%)

8. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 8 Only 51,2 % Percentage of CORRECT answers IC (95%): 50.5-51.9 1636 OPERATORS (DOCTORS & NURSES) Knowledge / Behaviours were interwieved on

9. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 9 THE EDUCATIONAL TRAINING

10. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 10 Introduction on HPH What is the HPH Network The importance of Pain Management in HPH The Policentric Survey of HPH Veneto Region TRAINING CONTENTS Theoretical Contents ”Practical” Contents Physiopathology and pharmacology of pain Pain management throught the eyes of different specialists: Internist, Surgeon, Oncologist, Paeditricians… Supported by a videocassette

11. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 11 Technical Aspects on pain measurement VIDEOCASSETTE Scenes Played by actors

12. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 12 A same Pain Scale is a MILESTONE for a common work Technical Aspects Presentation of the Pain Scale which were adopetd - Numerical Rating Scale (NRS) was adopted for adult patient - Easy to be used - Easy to show to patients how it works - Easy & Fast to record : the values are whole numbers N.R.S. 0 1 2 3 4 5 6 7 8 9 10 Absent pain The most severe imaginable pain

13. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 13 Young children do not understand the meaning of numbers Technical Aspetcs Bieri Scale in children 4-7 years old - What is the face that is like your pain ? 0 2 4 6 8 10 Absent pain The most severe imaginable pain

14. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 14 THE SCENES Actors play the scenes in the role of doctors, nurses and patients

15. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 15 First scene to be watched : INCORRECT beahviour (by doctors and nurses) in measuring pain in adult patient 3 SCENES ARE PLAYED Audience has to watch the incorrect scene Then a discussion is opened

16. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 16 Discussion facilities Booklet With notes to help the audience in observing the verbal and not verbal communication With the texts of the scripts played by actors With exercises: to write the correct conversation

17. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 17 After the discussion the other (correct) scenes are showed Second scene: Correct behaviour in measuring pain in adult patient Third scene: Correct behaviour in measuring pain in children

18. Health Promoting Hospitals Veneto Region Network 13 th International Conference on HPH – Dublin 18-20 may 2005 18 Veneto Region Govern Adopted this HPH Training for all the doctors and nurses of Veneto Region