The experiences of intensive care nurses in the assessment and intervention of pain relief in children

Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil, .
Revista da Escola de Enfermagem da U S P (Impact Factor: 0.45). 10/2012; 46(5):1074-1081. DOI: 10.1590/S0080-62342012000500006
Source: PubMed


Descriptive survey of daily practical experiences of pediatric nurses in the assessment and intervention to pain relief in children, during nursing care provided in pediatric and neonatal intensive care units, and the influence of the infrastructure of care and system organization. The sample was made up of 109 nurses. The principal results indicated that the majority of the nurses considered the academic training obtained as insufficient to support this aspect of nursing care; that they had not received local training in evaluating pain or in relief interventions; that the staff ratio is inadequate and as well as the availability of institutional guidelines to improve the quality of analgesia. It was concluded that nurses value the assessment and intervention to pain relief in children, but describe aspects which compromise practice: lack of collaborative practice, lack of processes definition, lack of formal and continuing education and lack of infrastructure. These aspects compromide the implementation of scientific evidences capable of improving practical aspects of analgesia in children under intensive care.

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    • "Pölkki et al. (2001) explain that it is important to be cognizant and respectful of the child's age and developmental level when information is given, so that it is accessible, appropriate and comprehensible to the child. Santos et al. (2012) show that several nurses had experiences with children who had suffered pain unnecessarily because of inadequate pain assessment. The parents in this study developed ambivalent feelings about ICU monitoring equipment. "
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    ABSTRACT: Background Intensive care of children means not only caring for a child; it means care for the whole family.AimThe aim of the study was to describe parents' experiences of having a critically ill child in an intensive care unit (ICU).ParticipantsA purposive sample of seven parents who had their child treated in an ICU during 2012 in Sweden.DesignThe design uses an inductive, qualitative approach with data collected by means of qualitative interviews.Methods The interviews were transcribed verbatim and subjected to qualitative content analysis.ResultsThe analysis resulted in one theme: the desire of parents to be involved and present, with four categories such as wanting to understand and know what is happening, feeling frustration about their child's care and treatment, a health care environment that arouses emotions, and needs for support and processing.Conclusion It is of great importance to parents to be informed continuously about their child's condition and the care and treatment that are planned. This may increase parents' sense of ownership, control and security.Relevance to clinical practiceProviding answers to those questions that can be answered and being available to parents when they have questions about their critically ill child, the meaning of it all, and what the future will hold are suggested in clinical practice.
    Nursing in Critical Care 09/2014; DOI:10.1111/nicc.12103 · 0.65 Impact Factor
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    ABSTRACT: To determine the efficacy of swaddling and heel warming on pain response in neonates following heel stick. Swaddling has been suggested to reduce pain response in neonates during heel stick. Heel warming is also often performed for drawing blood easily before heel stick. However, the efficacy of both on pain response is unclear. A randomised controlled study was used. Twenty-five neonates were randomly assigned to each of the control, swaddling and heel-warming groups. Heart rate, oxygen saturation Neonatal Infant Pain Scale and duration of crying were used to assess pain reactivity and pain recovery. A greater heart rate and Neonatal Infant Pain Scale increase, or oxygen saturation decrease, indicated higher pain reactivity. A longer duration of heart rate and oxygen saturation changes after heel stick back to baseline indicated a longer pain recovery. The decrease in oxygen saturation in swaddling group was significantly greater than that in heel-warming group. The increase in the Neonatal Infant Pain Scale in control group was significantly higher than that in swaddling group. The heart rate recovery time in control group and swaddling group was significantly longer than that in heel-warming group. The oxygen saturation recovery time in control group was significantly longer than that in heel-warming group. The duration of crying in control group was significantly longer than those in swaddling group and heel-warming group. Both swaddling and heel warming decreased the pain response of neonates during heel stick. Heel warming resulted in a lower pain response than did swaddling for neonates, particularly in terms of pain recovery. Heel warming could become a routine practice to decrease the pain response of neonates during heel stick.
    Journal of Clinical Nursing 01/2014; 23(21-22). DOI:10.1111/jocn.12549 · 1.26 Impact Factor


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