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Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study
Natália Pinheiro Braga Sposito1, Lisabelle Mariano Rossato2, Mariana Bueno2
1MSc, RN, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil. Professor, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
Insights
Neonatal pain is frequent, with over half of hospitalizations recording pain. Despite numerous daily invasive procedures, pain relief interventions are underutilized, indicating undertreatment in Neonatal Intensive Care Units.
Area of Science:
- Neonatal care
- Pain management
- Clinical research
Background:
- Pain is a significant concern in Neonatal Intensive Care Units (NICUs).
- Effective pain assessment and management are crucial for infant well-being.
- Understanding the frequency of pain and interventions is vital for improving care standards.
Purpose of the Study:
- To determine the incidence of pain in newborns during the first seven days of NICU hospitalization.
- To evaluate the pain relief measures employed during this period.
- To identify the types and frequency of invasive procedures newborns undergo.
Main Methods:
- A cross-sectional retrospective study was conducted.
- Data were collected from 171 out of 188 hospitalizations over a 12-month period.
- Pain was assessed using the Neonatal Infant Pain Scale and nursing notes; statistical analysis used SPSS.
Main Results:
- Pain was recorded in 50.3% of hospitalizations, based on the pain scale or nursing notes.
- Newborns experienced an average of 6.6 invasive procedures daily.
- Only 32.5% of recorded pain instances led to pharmacological or non-pharmacological interventions.
Conclusions:
- Newborns in the NICU are frequently exposed to pain.
- The low rate of pain intervention suggests significant undertreatment of pain in this population.
- There is a need to enhance pain management strategies in neonatal intensive care.
Objective::
to determine the frequency of pain, to verify the measures adopted for pain relief during the first seven days of hospitalization in the Neonatal Intensive Care Unit and to identify the type and frequency of invasive procedures to which newborns are submitted.
Method::
cross-sectional retrospective study. Out of the 188 hospitalizations occurred during the 12-month period, 171 were included in the study. The data were collected from the charts and the presence of pain was analyzed based on the Neonatal Infant Pain Scale and on nursing notes suggestions of pain. For statistical analysis, the Statistical Package for the Social Sciences was used, and the significance level was set at 5%.
Results::
there was at least one record of pain in 50.3% of the hospitalizations, according to the pain scale adopted or nursing note. The newborns underwent a mean of 6.6 invasive procedures per day. Only 32.5% of the pain records resulted in the adoption of pharmacological or non-pharmacological intervention for pain relief.
Conclusion::
newborns are frequently exposed to pain and the low frequency of pharmacological or non-pharmacological interventions reinforces the undertreatment of this condition.
Objetivo::
determinar a frequência de dor e verificar as medidas realizadas para seu alívio durante os sete primeiros dias de internação na Unidade de Terapia Intensiva Neonatal, bem como identificar o tipo e frequência de procedimentos invasivos aos quais os recém-nascidos foram submetidos.
MéTodo::
estudo retrospectivo transversal. Das 188 internações ocorridas no período estipulado de 12 meses, 171 foram incluídas na pesquisa. Os dados foram coletados a partir dos prontuários e a presença de dor foi analisada tanto com base na escala de dor Neonatal Infant Pain Scale quanto mediante anotação de enfermagem sugestiva de dor. Para análise estatística, utilizou-se o programa Statistical Package for the Social Sciences, adotando-se nível de significância de 5%.
Resultados::
em 50,3% das internações houve ao menos um registro de dor, conforme escala de dor adotada ou anotação de enfermagem. Os recém-nascidos foram submetidos à média de 6,6 procedimentos invasivos por dia. Apenas 32,5% dos registros de dor resultaram na adoção de condutas farmacológicas ou não farmacológicas para seu alívio.
ConclusãO::
observa-se que os recém-nascidos são frequentemente expostos à dor e a baixa frequência de intervenções farmacológicas ou não farmacológicas reforça o subtratamento dessa condição.
Objetivo::
determinar la frecuencia del dolor, comprobar las medidas tomadas para su alivio durante los siete primeros días de internación en una Unidad de Terapia Intensiva Neonatal e identificar el tipo de procedimientos invasivos y la frecuencia a que se sometieron los recién nacidos.
MéTodo::
estudio retrospectivo transversal. De las 188 internaciones realizadas en el período estipulado de 12 meses, se incluyeron 171 en la investigación. Los datos se recolectaron a partir de los prontuarios; la presencia de dolor se analizó según la Escala de Valorización del Dolor en el Neonato (Neonatal Infant Pain Scale) y las notas de enfermería sobre el dolor. Para el análisis estadístico, se utilizó el programa 'Paquete estadístico para las ciencias sociales' (Statistical Package for the Social Sciences), adoptándose el nivel de significación del 5%.
Resultados::
en el 50,3% de las internaciones hubo al menos un registro de dolor, según la escala de dolor adoptada o las notas de la enfermería. Se sometió a los recién nacidos a un promedio de 6,6 procedimientos invasivos por día. Sólo el 32,5% de los registros de dolor resultaron en la adopción de conductas farmacológicas o no farmacológicas para su alivio.
ConclusióN::
se observa que los recién nacidos a menudo están expuestos al dolor, y la frecuencia baja de intervenciones farmacológicas o de las no farmacológicas refuerza el subtratamiento de dicha condición.
