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Supportive Interventions to Reduce Pain and Stress During Ophthalmic Examinations for Retinopathy of Prematurity in
Mikayla Pollaci1, Elizabeth A Schlenk, Caitlyn Baum
1University of Pittsburgh School of Nursing, Pennsylvania (Ms Pollaci and Drs Schlenk and Godfrey); and Behavioral Science Division, UPMC Children's Hospital of Pittsburgh, Pennsylvania (Ms Baum).
Insights
Supportive interventions during ophthalmic exams effectively reduce pain, bradycardic events, and stress cues in premature infants. These evidence-based methods can be integrated into standard unit protocols for improved infant care.
Area of Science:
- Neonatal care
- Ophthalmology
- Pediatric medicine
Background:
- Ophthalmic examinations cause significant pain and stress in premature infants.
- Evidence supports interventions but lacks standard implementation guidelines.
Purpose of the Study:
- Implement evidence-based supportive interventions during ophthalmic examinations for premature infants.
- Evaluate the impact on infant pain, oxygen saturation, heart rate, bradycardic events, and stress cues.
Main Methods:
- A preintervention and intervention group design was utilized.
- Primary outcomes included pain and oxygen saturation.
- Secondary outcomes measured heart rate, bradycardic events, and neonatal stress cues.
Main Results:
- Supportive interventions significantly reduced pain during and after examinations.
- Bradycardic events and neonatal stress cues were significantly decreased.
- A trend towards reduced pain before examinations was observed.
Conclusions:
- Supportive interventions are effective in mitigating pain, bradycardia, and stress during ophthalmic exams in premature infants.
- These interventions can be successfully implemented as a unit-based protocol.
- Further research is required to assess long-term outcomes.
Background:
Ophthalmic examinations are a frequent source of pain and stress in premature infants. There is evidence for the use of supportive interventions during infant ophthalmic examinations to reduce pain and stress, but there are no standard recommendations for their implementation.
Purpose:
The purpose of this quality improvement project was to implement evidence-based, supportive interventions during ophthalmic examinations in premature infants and evaluate the impact on pain, oxygen saturation, heart rate, bradycardic events, and neonatal stress cues.
Methods:
A preintervention and intervention group design was used. Primary outcomes were pain and oxygen saturation. Secondary outcomes were heart rate, number of bradycardic events, and number of neonatal stress cues. Independent-sample t tests were used to compare means of the measures in the preintervention and intervention groups.
Results:
Supportive interventions during ophthalmic examinations significantly reduced infant pain (during and after the examination), number of bradycardic events (during and after the examination), and number of neonatal stress cues (before, during, and after the examination). There was also a trend for supportive interventions to decrease pain before the examination.
Implications For Practice:
Supportive interventions during ophthalmic examinations are effective in reducing pain, bradycardic events, and neonatal stress cues in premature infants and can be successfully implemented as part of a unit-based protocol.
Implications For Research:
Future research is needed to determine the long-term outcomes associated with supportive interventions during ophthalmic examinations in premature infants.
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