A Multicenter Collaborative to Improve Postoperative Pain Management in the NICU.

Area of Science:

• Pediatric Surgery
• Pain Management
• Quality Improvement

Background:

• Postoperative pain in infants undergoing complex surgeries is a significant clinical challenge.
• Family satisfaction with pain management is a crucial outcome measure in neonatal intensive care units (NICUs).

Purpose of the Study:

• To decrease unrelieved postoperative pain in infants.
• To improve family satisfaction with pain management strategies.

Main Methods:

• A collaborative quality improvement project involving multiple NICUs within the Children's Hospitals Neonatal Consortium.
• Implementation of evidence-based interventions including standardized pain assessment, documentation, nonpharmacologic treatments, and multidisciplinary team communication.
• Data collection over three periods: baseline (Jan-Jul 2019), improvement (Aug 2019-Jun 2021), and sustain (Jul-Dec 2021).

Main Results:

• Unrelieved postoperative pain decreased by 35% (from 19.5% to 12.6%).
• Family satisfaction increased from 93% to 96%.
• Compliance with pain assessment and documentation improved from 53% to 66%, with a decrease in sedation scores.

Conclusions:

• Standardized pain management and interdisciplinary workflow in the postoperative period significantly improve pain control in infants.
• Multidisciplinary collaboration and adherence to evidence-based practices are key to successful quality improvement initiatives in NICUs.