The opinions of clinical staff regarding neonatal procedural pain in two Norwegian neonatal intensive care units
Randi Dovland Andersen
Department of Paediatrics, Telemark Hospital, Skien, Norway
Search for more papers by this authorMargrethe Greve-Isdahl
Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway
Present address: Department of Paediatrics, Rikshospitalet/Radiumhospitalet University Hospital, Oslo, Norway
Search for more papers by this authorLeena Jylli
Department of Woman and Child Health, Karolinska Institutet and Acute Pain Treatment Service, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
Search for more papers by this authorRandi Dovland Andersen
Department of Paediatrics, Telemark Hospital, Skien, Norway
Search for more papers by this authorMargrethe Greve-Isdahl
Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway
Present address: Department of Paediatrics, Rikshospitalet/Radiumhospitalet University Hospital, Oslo, Norway
Search for more papers by this authorLeena Jylli
Department of Woman and Child Health, Karolinska Institutet and Acute Pain Treatment Service, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
Search for more papers by this authorAbstract
Aim: Neonates are subjected to numerous painful procedures without sufficient pain management. The aim of this study was to describe the opinions of Norwegian physicians, nurses and nurse assistants who care for neonates, regarding procedural pain in neonates.
Methods: A replication of a previous questionnaire study was conducted in two Norwegian neonatal intensive care units (NICU's). The questionnaire aimed at evaluating procedure painfulness, the current use of pharmacological agents and comfort measures and the optimal use of both.
Results: Ninety members of the clinical staff participated, which is a response rate of 87%. Opinions on how procedural pain is currently and optimally managed differed significantly. Although most respondents rated a majority of the listed procedures as being more than moderately painful, pharmacological agents were rarely used, except for the insertion of a chest tube and endotracheal intubation. Comfort measures were also believed to be underutilized, but not to the same degree as pharmacological agents.
Conclusion: Procedural pain in neonates is not sufficiently managed and both pharmacological agents and comfort measures are underutilized, according to clinicians at two Norwegian NICU's.
References
- 1 Barker DP , Rutter N . Exposure to invasive procedures in neonatal intensive care unit admissions . Arch Dis Child Fetal Neonatal Ed 1995 ; 72 : F47 – 8 .
- 2 Johnston CC , Collinge JM , Henderson SJ , Anand KJ . A cross-sectional survey of pain and pharmacological analgesia in Canadian neonatal intensive care units . Clin J Pain 1997 ; 13 : 308 – 12 .
- 3 Porter FL , Anand KJ . Epidemiology of pain in neonates . Res Clin Forums 1998 ; 20 : 9 – 18 .
- 4 Simons SH , van Dijk M , Anand KS , Roofthooft D , van Lingen RA , Tibboel D . Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates . Arch Pediatr Adolesc Med 2003 ; 157 : 1058 – 64 .
- 5 Coskun V , Anand KJS . Development of supraspinal pain processing . In : KJS Anand , BJ Stevens , PJ McGrath , editors . Pain in neonates . 2nd Revised and Enlarged ed . Amsterdam : Elsevier , 2000 .
- 6 Fitzgerald M . Development of the peripheral and spinal pain system . In : KJS Anand , BJ Stevens , PJ McGrath , editors . Pain in neonates . 2nd Revised and Enlarged ed .. Amsterdam : Elsevier , 2000 .
- 7 Anand KJ . Consensus statement for the prevention and management of pain in the newborn . Arch Pediatr Adolesc Med 2001 ; 155 : 173 – 80 .
- 8
Franck LS
,
Lawhon G
.
Environmental and behavioral strategies to prevent and manage neonatal pain
.
In
:
KJS Anand
,
BJ Stevens
,
PJ McGrath
,
editors
.
Pain in neonates
.
2nd Revised and Enlarged ed
.
Amsterdam
:
Elsevier
,
2000
.
10.1007/978-3-322-95155-7_11 Google Scholar
- 9 Prevention and management of pain and stress in the neonate. American Academy of Pediatrics. Committee on Fetus and Newborn. Committee on Drugs. Section on Anesthesiology. Section on Surgery. Canadian Paediatric Society. Fetus and Newborn Committee . Pediatrics 2000 ; 105 : 454 – 61 .
- 10 Porter FL , Wolf CM , Gold J , Lotsoff D , Miller JP . Pain and pain management in newborn infants: a survey of physicians and nurses . Pediatrics 1997 ; 100 : 626 – 32 .
- 11 Dodds E . Neonatal procedural pain: a survey of nursing staff . Paediatr Nurs 2003 ; 15 : 18 – 21 .
- 12 Howell D , Butler L , Vincent L , Watt-Watson J , Stearns N . Influencing nurses' knowledge, attitudes, and practice in cancer pain management . Cancer Nurs 2000 ; 23 : 55 – 63 .
- 13 Camp-Sorrell D , O'Sullivan P . Effects of continuing education. Pain assessment and documentation . Cancer Nurs 1991 ; 14 : 49 – 54 .
- 14 Ger LP , Chang CY , Ho ST , Lee MC , Chiang HH , Chao CS , et al . Effects of a continuing education program on nurses' practices of cancer pain assessment and their acceptance of patients' pain reports . J Pain Symptom Manage 2004 ; 27 : 61 – 71 .
- 15 Francke AL , Luiken JB , de Schepper AM , Abu-Saad HH , Grypdonck M . Effects of a continuing education program on nurses' pain assessment practices . J Pain Symptom Manage 1997 ; 13 : 90 – 7 .
- 16 Francke AL , Luiken JB , Garssen B , Abu-Saad HH , Grypdonck M . Effects of a pain programme on nurses' psychosocial, physical and relaxation interventions . Patient Educ Couns 1996 ; 28 : 221 – 30 .
- 17 Halimaa SL . Pain relieving measures for procedural pain in premature babies. An observational study . Vard Nord Utveckl Forsk 2001 ; 21 : 9 – 13 .
- 18 Halimaa SL , Vehvilainen-Julkunen K , Heinonen K . Knowledge, assessment and management of pain related to nursing procedures used with premature babies: questionnaire study for caregivers . Int J Nurs Pract 2001 ; 7 : 422 – 30 .
- 19 Jordan-Marsh M , Hubbard J , Watson R , Deon Hall R , Miller P , Mohan O . The social ecology of changing pain management: do I have to cry? J Pediatr Nurs 2004 ; 19 : 193 – 203 .
- 20 Jones KR , Fink R , Pepper G , Hutt E , Vojir CP , Scott J , et al . Improving nursing home staff knowledge and attitudes about pain . Gerontologist 2004 ; 44 : 469 – 78 .
- 21 Bardiau FM , Taviaux NF , Albert A , Boogaerts JG , Stadler M . An intervention study to enhance postoperative pain management . Anesth Analg 2003 ; 96 : 179 – 85 .
- 22 Juhl IU , Bulow HH , Nielsen PR , Videbaek B , Sonnenschein C . Management of postoperative pain. An intervention study . Acta Anaesthesiol Scand 1996 ; 40 : 852 – 7 .
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