Article Text

VARIABILITY OF ACUTE PROCEDURAL PAIN PRACTICES IN 8 CANADIAN PAEDIATRIC HEALTH CARE CENTRES
  1. B J Stevens1,
  2. F A Campbell2,
  3. G A Finley3,
  4. C Johnston4,
  5. M Latimer5,
  6. S LeMay6,
  7. J Rashotte7,
  8. D M Sawatzky-Dickson8,
  9. S Scott9,
  10. A R Synnes10,
  11. F Warnock11,
  12. The CIHR Team in Children’s Pain
  1. 1Centre for Nursing, The Hospital for Sick Children, Toronto, ON, Canada
  2. 2Department of Anaesthesia, The Hospital for Sick Children, Toronto, ON, Canada
  3. 3Paediatric Anaesthesia, IWK Health Centre, Halifax, NS, Canada
  4. 4School of Nursing, McGill University, Montréal, QC, Canada
  5. 5School of Nursing, Dalhousie University, Halifax, NS, Canada
  6. 6Faculté Des Sciences Infirmières, Université de Montréal, Montréal, QC, Canada
  7. 7Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
  8. 8Neonatal Intensive Care Unit, Children’s Hospital of Winnipeg, Winnipeg, MB, Canada
  9. 9Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
  10. 10Division of Neonatology, British Columbia Children’s Hospital, Vancouver, BC, Canada
  11. 11School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada

Abstract

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.

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