BACKGROUND: Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. METHODS: We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ(2)) analyses. RESULTS: Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. INTERPRETATION: For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit.
BACKGROUND:Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. METHODS: We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ(2)) analyses. RESULTS: Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. INTERPRETATION: For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit.
Authors: Sinno H P Simons; Monique van Dijk; Kanwaljeet S Anand; Daniella Roofthooft; Richard A van Lingen; Dick Tibboel Journal: Arch Pediatr Adolesc Med Date: 2003-11
Authors: Bonnie Stevens; Patrick McGrath; Marilyn Ballantyne; Janet Yamada; Annie Dupuis; Sharyn Gibbins; Linda Franck; G Allen Finley; Alexandra Howlett; Celeste Johnston; Karel O'Brien; Arne Ohlsson Journal: Eur J Pain Date: 2010-01-04 Impact factor: 3.931
Authors: Sian Cotton; Christina M Luberto; Lois H Bogenschutz; Terri J Pelley; Jeffrey Dusek Journal: J Altern Complement Med Date: 2013-10-31 Impact factor: 2.579
Authors: Alison M Twycross; Jill Maclaren Chorney; Patrick J McGrath; G Allen Finley; Darlene M Boliver; Katherine A Mifflin Journal: Pain Res Manag Date: 2013 Sep-Oct Impact factor: 3.037
Authors: Kathryn A Birnie; Christine T Chambers; Conrad V Fernandez; Paula A Forgeron; Margot A Latimer; Patrick J McGrath; Elizabeth A Cummings; G Allen Finley Journal: Pain Res Manag Date: 2014-05-07 Impact factor: 3.037