Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study.
Natália Pinheiro Braga Sposito, Lisabelle Mariano Rossato, Mariana Bueno and 3 others
PMID 28902934WHAT IT FOUND
Pain was recorded in 50.3% of NICU newborn hospitalizations, but relief measures were registered in only 32.5% of those pain records.
No pharmacological intervention was recorded for more than 96% of procedures.
Key findings
01Pain was recorded in 50.3% of hospitalizations, but relief interventions were registered in only 32.5% of pain records.
02No non-pharmacological interventions were recorded for procedures, and no pharmacological intervention was registered for more than 96% of procedures.
03The pain scale was applied 3,884 times, but only 3 applications were after procedures and 11 were reassessments after pain relief.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and used only one neonatal intensive care unit, so the records may not represent other hospitals. Because data came from charts, missing documentation may understate both pain and treatment. The pain scale was applied at scheduled times and rarely after procedures or for reassessment, so procedural pain may be missed. The study counted scores above zero as pain, although the paper says scores higher than 3 indicate pain. The 171 hospitalizations included 150 newborns, because some were rehospitalized, so the analysis is of hospitalizations rather than of individual children.
The easy way to misread this
Do not read the 96.8% of pain-scale records showing no pain as proof that pain was rare. The scale was usually applied at scheduled hours, rarely after procedures or for reassessment, and chart records may be incomplete.