EPM: June 2016 Newsletter

980x325-EPM-main-page-banner

Essential Pain Management Newsletter

Welcome to the June edition of the Essential Pain Management Newsletter.  We have a lot of information for you on new developments, recent workshops and upcoming events.

New Developments

Exciting work has been going on since the EPM Planning Workshop in Melbourne in July 2015.  Here are just some of the new developments:

EPM iPhone app released

The EPM iPhone was released last month and is now available for free from the iTunes store – search for “Essential Pain”. The app is intended as a bedside pain management tool for people who have done EPM training.  Please download, use, evaluate, and share – and provide us with your feedback.

Work on an android version of the app is underway.  We will let you know as soon as it is available.

EPM promotional videos now available

In February, filmmaker Lauren Anders Brown worked with Roger Goucke, Linda Huggins, Gertrude Marun, Wayne Morriss and others to make five short EPM videos.  Most of the footage was shot during EPM Lite teaching in Papua New Guinea.

Three videos have been made for the EPM Instructor Workshop, as well as two promotional videos.  The promotional videos are now are available on the EPM Facebook page and the EPM webpage.

 

Alu’s Story tells the personal story of one of the EPM workshop participants, and Essential Pain Management gives an overview of the EPM program.

Please look at the videos and share with others.

 

Work on EPM materials continues

Significant work has been done on the EPM and EPM Lite slide sets and accompanying manuals and we are hoping to release the second editions of both EPM and EPM Lite on 2 September at the World Congress of Anaesthesiologists in Hong Kong.

The new slides have been rewritten in parts, new photos have been added and they will hopefully have a much newer, fresher look!  

Mike O’Connor and others have been revising the EPM pre- and post-tests and the new tests will be available at the WCA.

A new ‘flyer’ that can be tailored to specific countries with the new EPM logo and letterhead template is available here.  

Online EPM reporting tool
In order to simplify and improve our data collection, an online reporting tool has been designed to be easy to complete and to allow us to keep track of all the great EPM activities happening around the world.  It is great to see so many people already using the tool which is available here.

Please use this tool at the end of each EPM course or series of courses. If you are able to submit photos, participant lists or pre-post-test analysis please provide these by email attachment to epm@anzca.edu.au.

EPM Symposium at the World Congress of Anaesthesiologists
The 16th World Congress of Anaesthesiologists (WCA 2016) will be held in Hong Kong from 28 August to 2 September 2016.

We are planning an EPM Symposium on Friday 2 September.  This will be an opportunity for EPM instructors and other interested people to get together for an update of EPM activities, the launch of revised materials and brainstorming about future plans.  EPM will also feature during other sessions during the WCA.

Monitoring and evaluation
Qualitative research methods were discussed during the EPM Planning Workshop.  We have since purchased several Dictaphones for narrative evaluation and these were trialled in Cambodia in November and Tonga in December. We hope to develop templates that other people can access.  See below for Liz Bashford’s review of the narrative feedback from Tonga.  

EPM workshops during the last six months
EPM courses have been held in at least 15 countries.  Please find a summary below acknowledging the programs and instructors involved.

Course reports are available from here.

Date                         

Location

Program                           

Instructors

October 2015                      

Petrozavodsk, Russian Federation              

3 days

Angela Enright, Beverley Collette, Arena Spasova and Ann Ezhevskaia.                                                                                                       

November 2015                    

Hue, Vietnam

EPM Lite Instructor

Roger Goucke

November 2015

Phnom Penh, Cambodia

3 days. Instructors

Husni Tanra, Mary Cardosa, Roger Goucke and Cham Nan.

November 2015

Hanoi, Vietnam

3 days

Professor Nguyen Huu Tu, Dr Giang, Dr Ha, Dr Hoai, Thomas Gosinski, Helen Loan and Kate Drummond.

November 2015

El Salvador, Central America

1 day

Carolina Haylock Loor.

December 2015

Minsk, Belarus

3 days

Alexander Dzyadzkl, Andrey Minou, Wayne Morriss, Michael O’Connor, Arena Spasova and Anna Ezhevskaia.

December 2015

Belgrade, Serbia

3 days

Miodrag Milenovic, Wayne Morriss, Dusica Simic, Michael O’Connor and Viktor Krubicht.

December 2015

Tonga

One day course linked with an Interplast surgical visit

Liz Bashford, Dr Matamoana Tupou and Sister ‘Ofa Vea,

December 2015

Pasig City, Philippines

3 days

Joslyn Que, Angelo Boblete, Anniela Soliven and Genecar Pe Benito.

January 2016

Mandalay, Myanmar

3 days

Professor Maung Maunghtwe, Peter Cox, Tom Flett, Ebrahim Phan and Roger Goucke.

February 2016                          

Kiribati, South Pacific

3 days

Dr Tekeua Uriam, Dr Hilda Schutz, Dr Emily Stimson, Maurice Hennesy and Roger Goucke. 

February/
March 2016       

Port Moresby, Papua New Guinea

3 days

Gertrude Marun, Pauline Wake, Linda Huggins and Roger Goucke.

March 2016

Blantyre, Malawi

3 days

Dr Karen Gilmore, Mrs Linly Kaneka, Dr Samantha Jayaweera and Dr Kieran Burton. Report can be found here.

March 2016

Lilongwe, Malawi

3 days

Dr Karen Gilmore, Mr William Banda and Mr Onias Ofmtalimanja. Report can be found here.

April 2016

Bahir Dar, Ethiopia

2 full EPM courses,
1 instructor workshop and 4 EPM Lite workshop

Dr Angela Enright and Dr Miodrag Milenovic.

May 2016

Madagascar

5 days

Dr Clare Roques and Dr Jane Mills.

June 2016

Ulaan Baator, Mongolia

Three separate EPM one day courses

Tipu Aamir, Jennifer Reilly, Amutha Samuel, Allysan Armstrong-Brown and Roger Goucke.

Upcoming EPM Workshops  
July 2016:  Argentina
August 2016: Nicaragua, South Africa

EPM Workshop Reports

India 2014 and 2015
EPM has been fortunate in partnering with India’s Travelling Pain School and it is good to report that after the introduction of EPM and EPM Lite to India at Hyderabad (Telangana), a large number of medical students, interns, nursing students, nurses and physiotherapists have been taught.  Following initial training of 25 instructors there are now 110 instructors teaching EPM in India and over 1,500 medical school participants have attended an EPM Lite program.  

Plans for the EPM program and the Travelling Pain School in India include: studying the social economic and psychological impact of teaching EPM; researching the change in attitudes in clinical practice following introduction to EPM;  attempting to influence policy and curriculum change at the medical council and government levels in India.  This is a terrific effort from our Indian colleagues and one we hope to continue to support.

Tonga EPM and Interplast December 2015
As a follow-up to the discussion we had at the EPM workshop in June 2015, during a recent visit to Tonga with an Interplast team Liz Bashford provided a medium-term assessment of the effect of EPM on this Pacific Island.  One technique Liz used was to review spot audits of medication charts of inpatients on medical, surgical and paediatric wards.  Outcomes from the audit identified incorrect drug doses and drugs written in two places which caused some confusion for nursing staff. A positive finding was the good documentation of pain assessment and drug treatment in the nursing notes and that paracetamol was being given regularly.

Liz also carried out some ‘most significant change’ interviews and noted that the hardest part was actually finding the 18 people who are still working at the hospital and had previously done EPM and were on duty!

Comments included:

Doctor, Anaesthetic trainee – EPM in Suva 2012:

  • Classification of pain and stratification of severity determines management
  • Useful in recent outbreak of sever viraemia (dengue-like syndrome)

Doctor, Resident – EPM in May 2013:

  • I now use amitriptyline for diabetic patients (with peripheral neuropathy)

Nurse – ICU and Post-op recovery – EPM in May 2012:

  • … make them more comfortable before returning to ward
  • More confident giving opiates
  • Need more EPM courses

Nurse – A&E – EPM in May 2013:

  • Pain is now part of the triage form assessment
  • Pain rating now written in nursing notes for patients in A&E

Ethiopia in April 2016
Dr Miodrag Milenovic and Dr Angela Enright ran 2 full EPM courses, 1 instructor workshop and 4 EPM Lite workshops at Gamby Hospital in Bahir Dar, Ethiopia and successfully trained 45 health professionals, 10 instructors and 64 students of the health sciences

Organising the printing for all of these courses proved to be fairly difficult as none of the print shops in Bahir Dar could manage this volume of material; neither could they print in colour. Eventually the right man to take charge of things and get things done was located at the hospital and he effectively negotiated very favourable prices including the colour printing of the certificates. Then, the hospital was also able to do a small amount of last minute printing. Due to the large numbers, it was decided to omit manuals for all of the students and the Vice-Dean Academic of the College was given the electronic material to send to the students who wanted it. All participants were provided with notebooks and pens.

Perhaps the best measure of the success and relevance of these EPM workshops was the improvement in the pain management of the burn post-op patients. For the first couple of days while the EPM courses were being set up, the Restor team kept telling us that they could not persuade the nurses to give the pain medication that was ordered. The Restor team (a Canadian non-government organisation supported by Rotary Clubs in British Columbia and Rotary International) did a lot of blocks but these would wear off later in the day or evening and when they came to make rounds early in the morning many of the patients were in agony. Within days of the EPM courses, the Restor team could see the difference. Nurses were asking patients about pain, measuring it and giving the pain medication on time. The nurses were very pleased to see their patients doing better and began to truly believe that patients do not have to be in pain and that they could do something about it. Everyone was happy and it was great to see immediate results.

Thank you to Restor International who paid for the printing which cost about $US300. (Including the manuals for professional participants, instructors’ manuals for the instructor course, pre- and post-tests, evaluation forms and certificates for everyone).

Other EPM News

EPM is on the map!
The Global Anaesthesia Partnerships Map is a collaborative tool developed by the Association of Anaesthetists of Great Britain and Ireland to profile and connect anaesthesia programs organised in low and middle income countries.  A wide range of educational and clinical projects are shown, including EPM.

The Global Anaesthesia Partnerships Map can be found here.

EPM Lite in the United Kingdom
EPM Lite has been fully established at 6 medical schools and 2 further medical schools are piloting the program during the 2016/2017 academic year.

The EPM Lite webpage can be found here.

Presentations
Roger Goucke gave an update on EPM and its place in education for LMICs at the Australian Pain Society Annual Scientific Meeting in Perth in March 2016.
Mike O’Connor presented EPM Lite at the British Pain Society’s Annual Scientific Meeting in May 2016.

French EPM
EPM was held for the first time in Madagascar in May 2016. The workshops, funded by the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland, were run by two UK Anaesthetists, Clare Roques and Jane Mills in conjunction with Mercy Ships.

The course was run in French using translated EPM materials initially compiled by Toby Nichols and updated by the instructors and the Mercy Ships team.  The candidates seemed to benefit from having all materials in a format which they could understand and there was a clear advantage in having instructors with at least a working knowledge of French. Perhaps not surprisingly, given that the French materials have been used so few times, there were some inconsistencies and typos. Trying to cross-reference English and French slides and to find appropriate pages in the French manual was much helped by being able to roughly translate the material between the two languages.  Delivery of the lectures themselves was largely done through interpreters but this did detract too much from the course. By the end of the four days the bright young translators could have delivered many of the talks and fielded questions themselves! The same team are planning another set of EPM workshops in francophone Africa.

 

ANZCA: The Australian and New Zealand College of Anaesthetists (ANZCA) is the professional medical body in Australia and New Zealand that conducts the education, training, and continuing professional development of anaesthetists and specialist pain medicine physicians.

Disclaimer: The Australian and New Zealand College of Anaesthetists (“College”) cannot be held responsible for any errors or omissions or any consequences from the use of information contained in this newsletter. The views and opinions expressed do not necessarily reflect those of the College, neither does the publication of announcements or advertisements necessarily constitute endorsement by the College of the matters referred to in these announcements or advertisements.

Log In