Nurses' underuse of non-pharmacological pain relief interventions in preterm infants

The aim of this literature review was to explore nurses' underuse of non-pharmacological pain relief interventions for minor procedures in preterm infants on neonatal intensive care units (NICUs). A search of the literature using keywords was undertaken using multiple databases. After inclusion and exclusion criteria were applied, three main themes emerged from 11 studies: preterm infant factors; nurse factors; and organisational factors. The literature review found that nurses consistently underused non-pharmacological pain relief interventions for minor procedures in preterm infants. Several contributory factors were identified, including the absence of pain guidelines, the quality of nurses' training and education, patient acuity, the lower gestational age of patients, and the intensity level of NICUs. Recommendations for future practice include the implementation of pain guidelines and validated pain assessment tools via neonatal clinical networks and local pain champions. Effective dissemination of education and training for nurses in pain affecting preterm infants is also required to overcome barriers such as staff shortages and excessive workloads.