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Mandatory Pain Assessment in a Pediatric Emergency Department: Failure or Success?: A Retrospective Study

Federico Marzona1, Sara Pedicini2, Eva Passone3

  • 1Department of Medicine (DAME), "S. Maria della Misericordia" Academic Hospital, University of Udine.

The Clinical Journal of Pain
|July 6, 2019
PubMed

Insights

Mandatory pain scoring in pediatric emergency services increased pain evaluation rates. However, this did not lead to improved pain treatment or management for children.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Triage
  • Pain Management

Background:

  • Pain assessment and treatment are critical in pediatric emergency care.
  • Current guidelines exist, yet pain remains underassessed and undertreated in children.
  • Implementing mandatory pain scoring in triage aims to improve pain evaluation efficiency and adherence to best practices.

Purpose of the Study:

  • To evaluate the impact of mandatory versus routine pain scoring on pain management in a pediatric emergency department.
  • To test the hypothesis that mandatory pain assessment enhances pain reevaluation and treatment.

Main Methods:

  • A retrospective case-control study was conducted in a Pediatric Emergency Department.
  • Data on pain assessment, reassessment, and administered analgesics were collected for two groups of patients.
  • The intervention group (1262 patients) used upgraded triage software with mandatory pain scoring, compared to the control group (1274 patients) using older software.

Main Results:

  • Pain evaluation occurred significantly more often in the intervention group at triage, during medical evaluation, and at discharge.
  • A smaller proportion of patients in the intervention group received pain treatment at triage and during their ED stay (P=0.078 and 0.048).
  • Pain reassessment rates were lower in the intervention group (P<0.01).

Conclusions:

  • Mandatory pain assessment protocols significantly increase the frequency of pain evaluations in pediatric emergency settings.
  • Despite improved evaluation rates, mandatory pain scoring did not demonstrably enhance pain treatment or overall pain management outcomes.
  • Further strategies are needed to translate increased pain assessment into improved clinical outcomes for pediatric patients.
Abstract

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