Evaluating the effectiveness of pediatric pain management guidelines.

In response to unit nursing quality and patient satisfaction concerns, the shared governance councils identified opportunities to improve overall assessment and management of pain in hospitalized pediatric patients. Together, the unit-shared governance councils evaluated current practice and reviewed the literature to develop comprehensive Pediatric Pain Assessment and Management Guidelines. The purpose of this study was to evaluate the effectiveness of implementing an evidence-based pain assessment and management guideline on nurses' knowledge, ability to assess and manage the patients' pain, and patient/family satisfaction with staff's management of pain. This intervention study with a pre-post design included three assessment intervals described as baseline and 3 and 6 months after guideline implementation. The sample included pediatric and pediatric intensive care unit (PICU) nursing staff, retrospective chart reviews of pediatric and PICU patients, and patient/parent satisfaction scores. No differences were found between nurses' knowledge and attitudes regarding pain before and after implementation of the guideline. Significant increases in pain assessment, use of correct tool, and reassessment were found following implementation. Although improving, there was no difference in patient/family satisfaction after guideline implementation.