Nurses' knowledge and practices regarding pain management in newborns.

Taine Costa,Natália Pinheiro Braga Sposito,Izabela Linha Secco,Lisabelle Mariano Rossato,Júnia Selma De Freitas,Denise Harrison,Mariana Bueno

doi:10.1590/s1980-220x2016034403210

Abstract

To analyze nurses' knowledge and practices regarding pain management of newborns admitted to Neonatal Intensive Care Units. A descriptive and cross-sectional study. Data were collected from 51 nurses based on an adapted questionnaire aimed at evaluating knowledge and practices regarding the management of neonatal pain in six hospitals in Curitiba and its Metropolitan Region. For most nurses (86.0%), neonates feel pain. A total of 34.7% of the nurses reported never using pain assessment scales. Pain management was recorded by 84.3% of the nurses. Administered pharmacological measures were Paracetamol and Fentanyl (47.1%) and Morphine (17.6%); while non-pharmacological measures adopted were sweetened solution (68.6%), non-nutritive sucking (58.8%) and positioning (56.9%). Nurses considered neonatal pain a real event; however, they do not perform pain assessment or treatment of newborns in a systematized way.It is necessary to implement knowledge translation strategiesin order to improve pain management in newborns. Verificar o conhecimento e as práticasdos enfermeiros sobreo manejo da dor de recém-nascidos admitidos em Unidades de Tratamento Intensivo Neonatal. Estudo descritivo e transversal. Os dados foram coletados com 51 enfermeiros, a partir de um questionário adaptado que visa avaliar o conhecimento e as práticas sobre o manejo da dor neonatal, em seis hospitais de Curitiba e Região Metropolitana. Para a maioria dos enfermeiros(86,0%), os neonatos sentem dor. Um total de 34,7% afirmaramnunca utilizar escalas de avaliaçãoda dor. O registro do manejo da dor foi realizado por 84,3% dos enfermeiros. As medidas farmacológicas realizadas foram Paracetamol e Fentanil (47,1%) e Morfina (17,6%);as não farmacológicas adotadas foram solução adocicada (68,6%), sucção não nutritiva (58,8%) e posicionamento (56,9%). Os enfermeiros consideraram a dor neonatal como um evento real, porém não realizavam avaliação ou tratamento da dor no recém-nascido de modosistematizado. É necessário implementarestratégias de tradução do conhecimento paraaprimorar o manejo da dor de recém-nascidos.

Highlights

The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential injuries
Newborns admitted to Neonatal Intensive Care Units (NICUs) are constantly exposed to painful procedures of varying intensities such as surgeries, tracheal cannula aspirations, and venous punctures, among others[3]
This study demonstrated that most nurses have knowledge about the importance of using and systematizing scales for assessing neonatal pain, but did not always use them

Summary

Introduction

The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential injuries. Each individual learns the application of the word pain through experiences related to illness early in life”(1). This definition has been challenged because of the inability of newborns to verbalize their pain, considering that an absence of verbal communication does not prevent one from experiencing pain and needing treatment[2]. Newborns experience numerous painful experiences as early as the first days of life, such as the intramuscular administration of vitamin K and skin perforation to measure blood glucose. Newborns admitted to Neonatal Intensive Care Units (NICUs) are constantly exposed to painful procedures of varying intensities such as surgeries, tracheal cannula aspirations, and venous punctures, among others[3]

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Discussion

Conclusion