Background and aim To assess the knowledge, perceptions, and practices of the neonatal intensive care unit (NICU) nurses on pain management.

Method In this study, a cross-sectional descriptive questionnaire, which consisted of 39 questions, was performed to nurses working in tertiary level NICUs.

Results Of the 97 nurses from six hospitals, 44 were working in public hospitals, and 53 were working in private hospitals. About half of the participants (%51.6) had completed an undergraduate degree, 56.7% were between the ages of 21–29 years, and 84.5% had less than 10 years working experience. Some of them (16.5%) were trained for the pain management. Most of the participants (86.6%) agreed that term infants are able to sense pain, however, fewer of them (69%) expressed that newborns are more sensitive to pain than older infants and adults. Most of the participants (85.2%) thought that one of the main duties of the NICU nurses is to recognise and prevent the pain. Only 29.9% of the nurses reported to use pain assessment tools, but 7.2% of them use it regularly. The use of pain assessment tools was significantly higher in public hospitals (p<0.05). Some of the participants (24.7%) have a protocol for the pain management in their units. Just 11% of the participants had read the national pain guideline. The insertion of feeding catheter and respiratory physiotherapy were the least painful procedures, while the insertion of a chest tube was the most painful procedure. Although 61.8% of the participants agreed that non-pharmacologic interventions were effective in the pain management, only 38.2% of them thought that they were sufficient for practicing these interventions. Giving a pacifier and oral sweet solution were the most commonly used non-pharmacological interventions. The most of the participants (62%) disagreed that parents should attend to painful procedures. Using an easily understandable and clinically feasible pain protocol in NICUs and training of the health personnel were found the most important factors to increase the quality of pain management. Inadequate knowledge, the difficulty of using pain tools and the shortage of nurses were found the biggest barriers regarding pain management.

Conclusion This study showed that pain management was inadequate in the NICUs of our province, and that using a standard protocol, training and increasing the number of staff in NICUs should be needed to successful pain management.