The Kids Pain Collaborative: A Hybrid Type 3 Implementation Effectiveness Study Transforming Paediatric Pain Care in the Emergency Department.

The study was done in one large paediatric emergency department, so results may not transfer to other EDs. The COVID-19 pandemic overlapped with implementation, increasing presentations and changing staffing, isolation and patient flow; the authors say the pandemic's changing workload and care patterns could not be fully separated from the project's effects. Interrupted time series assumes stable model of care, patient flow and cohort, which was not fully met during the pandemic. The intervention was a multi-component package, so the contribution of any single strategy cannot be separated. Family findings come from 14 post-implementation interviews, so they are limited to a small purposive sample.

The authors declared no conflicts of interest. Funding was from Queensland Health, Health Innovation, Investment and Research Office and the Centaur Memorial Fund for Nurses.

Do not conclude that nurse-initiated analgesia made children receive pain medicine faster. Time to initial analgesia did not decrease, and the adjusted model showed a relative increase of 11%. Do not credit any one component of the Kids Pain Collaborative, because policy change, facilitation, education, dashboards, guides and family strategies were delivered together.