Routine Use of Analgesia for Venipuncture in a Tertiary Level Neonatal Intensive Care Setting: A Quality Improvement...

Area of Science:

• Neonatal care
• Pain management
• Quality Improvement

Background:

• Neonatal exposure to pain can alter future pain perception.
• Routine use of analgesia for painful procedures like venipuncture is lacking.
• Venipuncture is a common, yet painful, procedure in neonatal intensive care units.

Purpose of the Study:

• To implement a quality improvement (QI) study to increase analgesia use during neonatal venipuncture.
• To improve the routine administration of pain relief measures in neonates undergoing venipuncture.

Main Methods:

• A fishbone analysis identified barriers to analgesia use.
• Plan-Do-Study-Action (PDSA) cycles were employed, including provider education, and the use of mother's own milk, donor milk, and 25% dextrose.
• Interventions were implemented over 8 weeks, with subsequent monitoring for sustained use.

Main Results:

• Analgesia use increased from a baseline of 0% to 53% by the end of the PDSA cycles.
• Following interventions, analgesia use reached 60% and was sustained for 3 months.
• The QI model successfully identified and addressed barriers to effective pain management.

Conclusions:

• A QI approach effectively increased analgesia use during neonatal venipuncture.
• The study demonstrated a successful culture change in pain management practices.
• Implementing multimodal analgesia strategies is crucial for neonatal pain reduction.