Pediatric nurses' use of behaviors to make medication administration decisions in infants recovering from surgery.

Although behavioral observation is recommended as the primary pain assessment for the nonverbal postsurgical child, little is known about clinicians' use of observation in their medication administration decisions. Eight infants were videotaped after surgery and segments of the videotapes were categorized as medication inactive or medication active (assumed to relieve pain) based on the usual duration of infants' analgesics. Nurses (N=50) viewed these segments and mean percent agreement with the pharmacologic categorization was 54%. Agreement was high for medication active segments and low for medication inactive ones. Nurses reported using the pain behaviors described in the literature as well as other infant characteristics in their decision making. Infant behaviors observed in the medication inactive snippets were not suggestive enough of the presence of pain to result in the nurses choosing to medicate.