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Differences in Pediatric Pain Management by Unit Types.

Kelsea O'Neal1, Danielle Olds2

  • 1Delta, Staff Nurse, Children's Mercy Hospitals and Clinics, Children's Mercy Hospital, Kansas City, MO, USA.

Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing
|June 9, 2016
PubMed
Summary
This summary is machine-generated.

Pediatric pain management varies by hospital unit, with routine assessments but inconsistent interventions and reassessments. Pharmacologic methods are common, but pain AIR cycle completion differs across units.

Keywords:
Assessmentinterventionpainpediatricsreassessment

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Area of Science:

  • Pediatric Nursing
  • Pain Management
  • Healthcare Quality Improvement

Background:

  • Effective pain management is crucial for pediatric patient care and outcomes.
  • Understanding variations in pain management practices across different hospital units is essential for improving care standards.

Purpose of the Study:

  • To determine differences in pediatric pain management by unit type in US hospitals.
  • To compare unit-type rates of pain assessment, intervention, and reassessment (AIR).
  • To describe variations in pain assessment tools and interventions used across pediatric units.

Main Methods:

  • Cross-sectional design utilizing secondary analysis of 2013 National Database of Nursing Quality Indicators (NDNQI®) data.
  • Retrospective chart review of 984 pediatric units in 390 hospitals.
  • Descriptive statistics and Kruskal-Wallis/Wilcoxon-rank sum tests for data analysis.

Main Results:

  • Pain assessment was near-universal (99.6%), with surgical units reporting highest pain prevalence and Level 4 NICUs the lowest.
  • The Faces, Legs, Activity, Crying, and Consolability (FLACC) Scale was most common; NICU-specific tools (N-PASS, NIPS) were used in neonatal units.
  • 89.4% of patients in pain received interventions, and 83.6% were reassessed, with pharmacologic methods being most frequent.

Conclusions:

  • While pain assessment is routine, interventions and reassessments are less consistent across pediatric units.
  • Pain AIR cycle completion rates vary significantly by unit type.
  • Pharmacologic interventions are prevalent, highlighting a need for standardized, comprehensive pain management strategies.