Pain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals.
Danton Matheus de Souza, Caroline Knoner Monteiro, Lisabelle Mariano Rossato
PMID 39813433WHAT IT FOUND
All infants in a Brazilian NICU had painful procedures, but none were assessed with a pain scale, only 13.7% had documented pain, and only 2.8% were reassessed.
Breastfeeding and skin-to-skin care were common documented interventions.
Key findings
01All infants had at least one painful procedure, but no infant was assessed with a pain scale, and pain was documented in only 13.7%.
02Pain reassessment was documented for only 2.8% of infants.
03Documented pain was treated with fentanyl (25.9%), breastfeeding encouragement (86%), skin-to-skin contact or Kangaroo Mother Care (66.9%) and concentrated care or minimal touch (42.7%); nurses documented or prescribed non-pharmacological interventions in 34.4% of cases, physicians in 28.7% and physiotherapists in 18.9%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The study used medical records, so it could only report what was written down, not what actually happened at the bedside. The number of painful procedures performed was not fully documented, including failed attempts, so the true burden of procedures may be higher than recorded. No infant was assessed with a validated pain scale, and subjective notes such as crying or pain face may have missed pain. The findings come from one public teaching hospital NICU in Brazil, so other units may differ. The paper reports associations with prenatal care and length of stay, not proof that these factors caused the interventions.
The easy way to misread this
Do not read the low pain documentation as evidence that few infants felt pain. All infants had at least one painful procedure, no infant was assessed with a validated scale, and the authors state subjective documentation may have underestimated actual pain.