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A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan.
Mio Ozawa1, Kyoko Yokoo, Yuuki Funaba
1Midwifery and Maternal-Child Nursing, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan (Drs Ozawa and Oohira, Ms Funaba, and Ms Fukushima); Professor Emeritus, Hiroshima University, Hiroshima, Japan (Dr Yokoo); Department of Neonatology, Prefectural Hospital of Hiroshima, Hiroshima, Japan (Dr Fukuhara); Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama, Japan (Ms Uchida); Perinatal Center, Yamagata Prefectural Central Hospital, Yamagata, Japan (Dr Aiba); Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan (Ms Doi); Department of Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan (Dr Akira Nishimura); Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan (Dr Hayakawa); and Department of General Perinatology and Neonatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan (Dr Yutaka Nishimura).
A quality improvement program enhanced neonatal pain management in Japanese NICUs. This collaborative approach successfully bridged the gap between evidence-based practices and their implementation in neonatal intensive care units.
Area of Science:
- Neonatal care
- Quality improvement science
- Evidence-based practice implementation
Background:
- Guidelines for neonatal pain management exist, but Japan lacks systematic institutional support for evidence-based practices.
- Significant opportunities for improvement in neonatal pain management were identified in Japanese NICUs.
Purpose of the Study:
- To assess the effectiveness of a collaborative quality improvement program in enhancing pain management within Japanese neonatal intensive care units (NICUs).
Main Methods:
- Seven Japanese level III NICUs participated in a 12-month quality improvement program using an Institute for Healthcare Improvement collaborative model.
- Evidence-based practice points for pain management were developed and implemented using Plan-Do-Study-Act cycles.
- Pain management quality indicators were tracked over time, with statistical analysis using Jonckheere's trend test and the Cochran-Armitage test for trend.
Main Results:
- The collaborative program led to measurable improvements in neonatal pain management across all participating sites.
- All NICUs implemented new pain assessment tools and developed electronic medical record forms for comprehensive pain data capture.
Conclusions:
- Collaborative quality improvement initiatives are effective in enhancing neonatal pain management in NICUs.
- These programs offer a viable strategy for addressing evidence-practice gaps in neonatal intensive care settings.
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