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Pain management in children: assessment and documentation in burn units
H Köhler1, S Schulz, A Wiebalck
1University Children's Hospital, Düsseldorf, Germany. hkohler@helix.mgh.harvard.edu
Insights
Pediatric burn pain management is often insufficient, with inconsistent pain assessment and documentation by healthcare staff. Many desire improved pain therapy, standardized documentation, and enhanced training for better pediatric burn care.
Area of Science:
- Pediatric Burn Care
- Pain Management
- Healthcare Documentation
Background:
- Burns represent a significant source of severe pain, particularly in pediatric patients.
- Current pain management for children with burns is frequently suboptimal.
- Inadequate pain assessment and documentation hinder effective treatment.
Purpose of the Study:
- To investigate the current practices of pain assessment and documentation by physicians and nurses in pediatric burn patients.
- To evaluate the perceived sufficiency of pain management strategies.
- To identify areas for improvement in pediatric burn pain care.
Main Methods:
- Survey of physicians and nurses regarding pain assessment and documentation in pediatric burn patients.
- Analysis of perceived sufficiency of pain management during different care phases.
- Assessment of attitudes towards pain documentation and its relevance to therapy.
Main Results:
- Pain management was deemed sufficient for 80% of ventilated and 60% of non-ventilated pediatric burn patients.
- A minority of staff found pain management sufficient during dressing changes and nursing care.
- Pain documentation rates were low (38% physicians, 58% nurses), with limited use of standardized methods (<20%).
- 48% of physicians did not consider pain documentation relevant for further therapy.
Conclusions:
- Significant gaps exist in pediatric burn pain assessment and documentation practices.
- Healthcare professionals recognize the need for improved pain therapy, standardized documentation, and enhanced training.
- Implementing algorithms for analgesics and structured training are crucial for optimizing pediatric burn pain management.
Abstract:
Burns are considered to be among the most painful types of trauma. Especially the pain of children is often unsatisfactorily treated. This study investigates the assessment and documentation of pain by physicians and nurses in children suffering from burns. Pain management was considered sufficient in 80% of ventilated patients and in 60% of non-ventilated patients. The minority of the staff regarded pain management as sufficient during dressing changes after the acute phase and during nursing care. Thirty-eight per cent of the physicians and 58% of the nurses documented the pain. Standardized documentation was used by fewer than 20% of the staff. Pain documentation was not considered relevant for further therapy by 48% of the physicians. More than half of all participants believed that an improvement of the pain therapy performed in their hospital was necessary. Standardized documentation, an algorithm for the application of analgesics, and more training in pain management were desired by many staff members.
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