This study aims to improve pain management in Swiss nursing homes by addressing behavior change of the care workers with a multilevel intervention

Pain management in nursing homes often is inadequate despite the availability of evidence- based pain management guidelines. Barriers to pain management in nursing homes occur on several levels including lack of knowledge and negative beliefs towards pain of care workers.

For this embedded mixed-methods pilot study a convenience sample of maximum six nursing homes will be recruited. The planned intervention comprises the implementation of pain management policies, training of all care workers in pain assessment and management as well as training and introduction of a facility pain champion. Quantitative outcomes assessed at baseline, after three and six months include self-efficacy and attitudes to pain of care workers, functional interference from pain and pain intensity in residents. Feasibility and acceptability of the intervention and potential barriers to its implementation will be explored in focus groups and interviews.

Inclusion Criteria:

Care workers:

• Registered nurses, licensed practical nurses/certified caregivers, nursing assistants, nurse aides and other care workers from the participating nursing home
• Working in direct resident care
• Participating care workers have to be employed for at least one month at the data collection
• Students, apprentices and interns have to be employed at least six months in total
• Speak and understand German
• Older than 16 years

Residents:

• All residents living in a participating nursing home, older than 64 years
• Written informed consent to participate in data collection signed by the resident or in case of severe cognitive impairment by his/her legally acceptable representative

Exclusion Criteria:

Care workers:

• Temporary employment for less than six months

Residents:

• Critical current health status or terminal life situation
• Known life expectancy less than 3 months
• Short term residents (length of stay <6 months)