A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan.
Mio Ozawa, Kyoko Yokoo, Yuuki Funaba and 9 others
PMID 28114148WHAT IT FOUND
In Japanese NICUs, a pain quality improvement program increased use of recommended pain assessment tools and staff education.
Some pain care indicators did not improve, and no infant pain outcomes were measured.
Key findings
01All participating sites that did not already use a recommended pain assessment tool introduced one during the study: 1 site introduced the NIPS, 3 sites introduced the FSPAPI, and 1 site introduced both.
02At baseline, 188 nurses and physicians (36.3%) had undergone annual hospital pain management education; at 12 months, 491 (94.9%) had.
03Routine vital-sign pain monitoring was reported at 85.7 and pain measurement at 68 at 12 months, with significant trends (P=.000 and P=.001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 7 sites participated, so the trends are imprecise and may not apply to other units. The design was pre-/postintervention without a reported control group, so other changes could have affected the results. The intervention combined education, PDSA cycles, expert support, best practice information, and data reporting, so the contribution of any single component cannot be separated. Sites selected the quality indicators based on their own identified deficiencies. Data collection depended on site reporting and was not independently validated. The indicators focused on invasive bedside procedures and did not evaluate postoperative pain. The study measured pain care processes and documentation, not infant pain outcomes.
The easy way to misread this
Do not conclude this program reduced neonatal pain. It measured implementation of pain care indicators, not infant pain outcomes.