Procedural pain in neonates: Do nurses follow national guidelines? A survey to Swedish neonatal units

Abstract

PurposeTo investigate if nurses at neonatal units in Sweden have adopted national guidelines when neonates are exposed to intravenous catheter, capillary heel prick, venepuncture and injections, to identify the frequency of documentation of pharmacological and behavioural treatments and to compare the answers from the nurses with results from an earlier national survey completed by the chief neonatologists at the same units. Design and sampleFour nurses at a total of 44 neonatal units in Sweden, received questionnaires. A total number of 116 surveys were analysed (response rate 66%). Main outcome and resultsAll units had written guidelines for prevention and treatment of pain. Behavioural treatments were used in every painful procedure in the study, but only1/5 used EMLA® often or always. There was a higher tendency to document the use of drugs than behavioural treatments. The chief neonatologist reported higher use of glucose than did nurses. ConclusionsSwedish national guidelines are not used consistently in some neonatal units. There is a considerably larger cohort of nurses who use behavioural treatments, rather than using drugs when painful procedures are performed. It was also evident that it was more common to document the use of drugs than behavioural treatments.