Impact of an education programme for staff working with children undergoing painful procedures

Needle phobia is very common in children, particularly in those with chronic illness who may have to endure many painful procedures. A programme developed to educate paediatric healthcare professionals working with children undergoing painful procedures was evaluated to identify: (1) whether the education programme led to an increase in participating clinicians' knowledge and confidence; and (2) the effectiveness of the education programme in changing practice for patient care.

Five senior house officers undertook the one-hour training provided by the hospital play specialist. Questionnaires were completed by the clinicians at the beginning and end of the programme. Nurses reported on the clinicians' adherence to best practice. Twenty-one children who had undergone painful procedures were interviewed with their parents to assess their levels of pain, distress, satisfaction and coping style.

Participants had increased their knowledge of how to work with children undergoing painful procedures. The main changes in knowledge reported by the clinicians were involving the nurse and the play specialist, preparing the equipment out of sight of the child and using distraction techniques. Parents and children reported low levels of distress during painful procedures, high levels of satisfaction with the procedure and listed a number of coping strategies that helped the child, and the parent, to cope during the procedure. Staff reports indicated that the protocol for painful procedures and that techniques such as distraction were being used in the majority of cases to help the child to cope.

There are useful pain control techniques that can be taught relatively quickly by nursing staff to paediatric healthcare professionals that do make a substantial difference to the care of children.