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A Quality Improvement Project on Pain Management at a Tertiary Pediatric Hospital
Jodi Wilding1, Hailey Scott2, Victoria Suwalska3
1274065Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada.
Insights
This study assessed pediatric pain management, finding no improvements despite interventions. Further initiatives are needed to enhance pain control for hospitalized children.
Area of Science:
- Pediatric Healthcare
- Pain Management
- Quality Improvement
Background:
- Hospitalized children frequently experience moderate to severe pain.
- Painful procedures, particularly needle-related ones, are common.
- Current pain management strategies are often underutilized.
Purpose of the Study:
- To evaluate and enhance pain management practices in a pediatric teaching hospital.
- To identify gaps in pain assessment and treatment for hospitalized children.
Main Methods:
- A pre- and post-intervention study using the Health Quality Ontario Quality Improvement framework.
- Data collection involved chart reviews and surveys of children and caregivers.
- Assessed pain intensity, procedures, treatments, and satisfaction.
Main Results:
- Most children reported moderate to severe pain at both assessment points.
- Needle-related procedures were common, with infrequent use of pain management strategies.
- Despite feedback, no significant improvements in pain management were observed.
Conclusions:
- The study highlighted persistent challenges in pediatric pain management.
- Findings underscore the need for continued efforts and refined strategies to improve pain control in hospitalized children.
Abstract:
To assess and improve pain management practices for hospitalized children in an urban tertiary pediatric teaching hospital.
Methods:
Health Quality Ontario Quality Improvement (QI) framework informed this study. A pre (T1) - post (T2) intervention assessment included chart reviews and children/caregiver surveys to ascertain pain management practices. Information on self-reported pain intensity, painful procedures, pain treatment and satisfaction were obtained from children/caregivers. Documented pain assessment, pain scores, and pharmacological/non-pharmacological pain treatments were collected by chart review. T1 data was fed back to pediatric units to inform their decisions and pain management targets.
Results:
At T1, 51 (58% of eligible participants) children/caregivers participated. At T2, 86 (97%) chart reviews and 51 (54%) children/caregivers surveys were completed. Most children/caregivers at T1 (78%) and T2 (80%) reported moderate to severe pain during their hospitalization. A mean of 2.6 painful procedures were documented in the previous 24 h, with the most common being needle-related procedures at both T1 and T2. Pain management strategies were infrequently used during needle-related procedures at both time points.
Conclusion:
No improvements in pain management as measured by the T1 and T2 data occurred. Findings informed further pain management initiatives in the participating hospital.
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