Objective Acute procedural pain assessment and management in paediatric clinical settings remains suboptimal. The objective of this study is to determine current procedural paediatric pain practices in 8 Canadian paediatric healthcare centres. This is the first of three inter-related projects undertaken by the CIHR Team in Children’s Pain to enhance the translation of research on pain in children.
Methods Baseline data on pain assessments, pharmacological, physical, and psychological interventions during a 24-hr period were collected from 60 patient charts in each of 32 hospital units across 8 sites over a 2-month period. The types of units included medical (n = 14), surgical (n = 8), and critical care (n = 10).
Results In total, 1920 patient charts were reviewed and revealed substantial variability between the 8 sites. Evidence of pain assessment ranged from 43–83% while the use of physical and psychological strategies ranged from 5–52% and 2–55%, respectively. The use of pharmacological strategies was more consistent (55–88%). Variability, although less substantial, was also observed by unit type for pain assessment (56–76%) and the use of pharmacological (58–80%), physical (21–35%), and psychological (9–17%) interventions.
Conclusions There is substantial variability in paediatric pain practices across Canada. Although some variability was noted by type of unit, greater variability was observed by site, suggesting hospital culture (e.g., values, initiatives, leadership) may influence how paediatric pain is assessed and managed. These findings highlight the need for appropriate knowledge translation to better implement paediatric pain practices.