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Procedural pain in neonates in Australian hospitals: a survey update of practices
Jann Foster1, Kaye Spence, David Henderson-Smart
1School of Nursing and Midwifery, University of Western Sydney, Sydney, New South Wales, Australia. j.foster@bigpond.net.au
Insights
Awareness and use of breastfeeding and sucrose for neonatal procedural pain management in Australia have increased since 2004. Continued support is needed for wider adoption of evidence-based pain relief in neonates.
Area of Science:
- Neonatal care
- Pain management
- Evidence-based practice
Background:
- Procedural pain in neonates is a significant concern.
- Previous surveys in 2004 indicated suboptimal uptake of evidence-based pain management strategies.
Purpose of the Study:
- To assess the current uptake of evidence for managing procedural pain in neonates across Australia.
- To evaluate the use of breastfeeding and sucrose for pain relief.
Main Methods:
- An Australian-wide survey was conducted among eligible hospitals.
- Data collected on the use of clinical practice guidelines (CPGs), pain assessment tools, breastfeeding, and sucrose for procedural pain management.
Main Results:
- 39% of hospitals used a CPG for neonatal pain management, with higher use in intensive care units.
- Only 11% of units used a pain assessment tool, but 50-80% in higher-level care units.
- Awareness and use of breastfeeding (90% awareness, 78% use) and sucrose (79% awareness, 53% use) for procedural pain were reported.
- 89% of units reported using either breastfeeding or sucrose for pain management.
Conclusions:
- There has been an increase in the awareness and use of breastfeeding and sucrose for neonatal procedural pain since 2004.
- Continued resources, local champions, and a national interest group are recommended to further promote evidence-based pain management in neonates.
Aim:
The study aims to determine whether there has been improved uptake of the evidence for the management of procedural pain in neonates throughout Australia.
Methods:
An Australian-wide survey was undertaken to determine the use of breastfeeding and sucrose and whether a clinical practice guideline (CPG) or pain assessment tool was used.
Results:
Data were available from 196 (91%) of the 215 eligible hospitals. A CPG informed the management of neonatal pain in 76 (39%) of the hospitals. There was wide variation in their use between the states, and a significantly higher use of a CPG in higher-level care units. A pain assessment tool was only used in 21 (11%) of the units with greater use in the higher level care neonatal intensive care units (50%) and surgical neonatal intensive care units (80%). Awareness of breastfeeding for procedural pain was reported by 90% of the 196 respondents while 78% reported that it was actually used. Awareness of sucrose for procedural pain was lower than breastfeeding at 79%, with 53% reporting that they used sucrose in their unit. Overall, 89% of the respondents reported that either breastfeeding or sucrose was used for the management of procedural pain in their units.
Conclusion:
There has been an increase in awareness and use of sucrose and breastfeeding for procedural pain in Australia since previous surveys were undertaken in 2004. Continued resources, local pain champions and a national interest group to promote the use of pain management for procedural pain in neonates are needed for continued uptake of the evidence.
