Pain assessment and management in the NICU: analysis of an educational intervention for health professionals

Background: Despite scientific advances on pain measurement and intervention, pain management for infants has remained a challenge for health teams. This is because infants are not able to talk and defend themselves when they are in pain. Prevention of pain is important, not only because it is an ethical expectation, but also because repeated painful exposures can have harmful consequences. The aim of this study was to explore factors influencing neonatal pain management from the perspectives of nurses and physicians in a neonatal intensive care unit (NICU). Methods: A qualitative content analysis study was carried out. The participants were the nurses and physicians working in the NICU of Alavi medical training center in Ardabil, Iran. Twenty-five nurses took part in focus group discussions and five physicians attended private interviews. Four focus group discussions and five interviews were carried out until data saturation was ensured. Data analysis was performed using conventional content analysis. All the participants were provided with information about the purpose and the nature of the study, and provided informed consent. Results: Data analyses indicated two effective themes about barriers of implementation of infant pain management, namely "Individual Factors" and "Organizational Factors". The first theme consisted of the categories "knowledge of the personnel" and "commitment of the personnel". The second theme included three categories namely "pain control policy", "work environment condition" and "management issues". Conclusions: Our findings indicated that lack of educational courses, absence of an infant pain management policy, and management issues were the main obstacles in the way of implementation of infant pain management by nurses and physicians at the NICU. Therefore, strategies are required to reduce or remove these barriers.

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“…The results have also indicated a lack of theoretical knowledge about physiopathology of pain, its assessment, and interventions (25).…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Neonatal Pain Management from the Perspectives of Nurses and Physicians in a Neonatal Intensive Care Unit: A Qualitative Study

et al. 2017

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“…Pain management is complex and multifactorial; thus a deeper understanding of the barriers for proper and optimum pain management needs to be addressed in order to remedy the deficiencies among HCPs and improve patient care. Education and training of HCPs is an important intervention that improves their skills which reflects positively on the patients [31–34]. …”

Section: Introductionmentioning

confidence: 99%

Healthcare Providers’ Knowledge and Current Practice of Pain Assessment and Management: How Much Progress Have We Made?

Nuseir

Kassab

Almomani

2016

Pain Research and Management

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Context. Despite improvement in pain management and availability of clinical treatment guidelines, patients in Jordan are still suffering from pain. Negative consequences of undertreated pain are being recognized as a reason for further illnesses and poor quality of life. Healthcare providers (HCPs) are responsible for relieving pain of their patients. Objective. To evaluate the knowledge and attitudes of HCPs toward pain management in Jordan. Methods. A 16-item questionnaire with agree or disagree options was given to 662 HCPs in seven hospitals in Jordan who volunteered to participate in the study. Following data collection, the responses were coded and entered into SPSS. Results. There was a statistically significant difference (p < 0.004) in percentage scores between physicians (36%) and pharmacists (36%) versus nurses (24%). The level of knowledge was the best among physicians, followed by pharmacists specifically in the area of cancer pain management. Nurses scored the lowest for knowledge of pain assessment and management among HCPs. However, HCPs overall scores indicated insufficient knowledge specifically in relation to pain assessment and management among children.

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“…The development of its own protocol, as well as of awareness and involvement practices for all the staff in the transition process were some of the defined strategies. The use of pain assessment scales increased to 94.4% after the intervention, and 79.6% of the practitioners had perceived changes in pain assessment and management . Educational intervention such as intermittent, short practical programs and motivational encouragement has also been shown to be of benefit by providing empowerment for change in practice .…”

Section: Discussionmentioning

confidence: 99%

Neonatal pain: Knowledge and perception among pediatric doctors in Malaysia

Ishak

Nfe

et al. 2019

Pediatrics International

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Background Inadequate pain management is linked to potential neurodevelopmental and behavioral problems. Sufficient knowledge in neonatal pain is required to facilitate optimal pain management. The aim of this study was therefore to assess the knowledge and perception of pain experienced by neonates requiring intensive care among pediatric doctors working in a level III neonatal intensive care unit in Malaysian hospitals. Methods This was a cross‐sectional study conducted over a period of 18 months. A self‐administered questionnaire assessing knowledge and perception regarding neonatal pain was used. Results Twenty‐four hospitals participated in the study, with 423 respondents. The response rate was 85%. One hundred and ninety‐seven respondents (47%) were aware of tools for neonatal pain assessment, but only 6% used them in daily practice. Doctors with >4 years of experience in neonatal care had better awareness of available pain assessment tools (59.4% vs 40.9%, P = 0.001). Sixteen statements regarding knowledge were assessed. Mean score obtained was 10.5 ± 2.5. Consultants/specialists obtained a higher mean score than medical officers (11.9 vs 10.4, P < 0.001). More than 80% of respondents were able to discriminate painful from non‐painful procedures. Conclusion Clinicians involved in neonatal care, especially those with longer experience were knowledgeable about neonatal pain. Gaps between knowledge and its application, however, remain. Implementation of clinical guidelines to improve the quality of assessment and adequate pain management in neonates is recommended.

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Pain assessment and management in the NICU: analysis of an educational intervention for health professionals

Cited by 25 publications

References 12 publications

Factors Influencing Neonatal Pain Management from the Perspectives of Nurses and Physicians in a Neonatal Intensive Care Unit: A Qualitative Study

Factors Influencing Neonatal Pain Management from the Perspectives of Nurses and Physicians in a Neonatal Intensive Care Unit: A Qualitative Study

Healthcare Providers’ Knowledge and Current Practice of Pain Assessment and Management: How Much Progress Have We Made?

Neonatal pain: Knowledge and perception among pediatric doctors in Malaysia

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