2.50
Hdl Handle:
http://hdl.handle.net/10755/155777
Type:
Presentation
Title:
Evidence-based Pain Assessment in Children
Abstract:
Evidence-based Pain Assessment in Children
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Beoglos, Aris, PhD
P.I. Institution Name:Children's Hospital Medical Center of Akron
Title:Director
Objective: Pain has been identified as the fifth vital sign, signifying the importance of accurate pain assessment and effective pain management for pediatric nurses. A paucity of literature reporting nurses' assessment of pain in the pre-verbal child exists and reliability and validity have not been adequately established in pain assessment tools designed for use in infants and pre-verbal children. The most reliable measure of pain, self report, is not a developmentally appropriate assessment measure for use in the infant and pre-verbal child. As a result, in 1993, the FLACC infant pain assessment tool was adopted by the institution. The FLACC tool utilizes behavioral indicators in pre-verbal children related to Face, Legs, Activity, Cry and Consolability to assign a pain score from 0-10. The purpose of this presentation is to describe: 1) a descriptive survey study of current pain assessment practices of pediatric nurses; and 2) how a collaborative approach can be used to encourage evidence-based clinical practice. Design: Anecdotal reports of nurses' use of individual, subjective criteria to assess pain, rather than using FLACC assessment tool, created an inconsistency in practice that warranted investigation. A descriptive, survey study utilizing retrospective chart review, a survey of current pain assessment practices and focus groups were conducted. Sample: Retrospective chart review of 96 occurrences of infants ages birth -15 months who had undergone cleft lip and/or palate repair from 1997-1999 was performed. A convenience sample of 73 nurses (100% return rate) on the infant unit completed surveys about their pain assessment practices. Additional information was provided by 26 nurses attending 5 focus groups. Variables Studied: Data collected from chart review included demographics, operative procedure performed, hours post operation, associated nursing pain assessment documentation and medications administered for pain relief. A Pain Assessment Questionnaire and a Focus Group Interview Guide provided data from nurses about: 1) how often pain is assessed; 2) tools or behavioral cues used to assess pain; 3) how often the FLACC scale is used; 4) ease of use of the FLACC scale; and 5) why the nurse does or does not use the FLACC scale. Methods: Chart reviews were conducted by nursing staff volunteers to meet requirements of the hospital career ladder. The research team conducted standardized training of data collectors and random inter-rater reliability checks were conducted to ensure consistency of data collection methods. A Pain Assessment Questionnaire was distributed to staff nurses on the infant unit to determine current pain assessment practices. Focus groups with nurses on the infant unit were scheduled on all shifts and provided additional in-depth information about nurses' pain assessment practices. Findings: Only 19% of charts identified the FLACC scale as the pain assessment method used. Similarly, while nurses reported assessing pain every hour in the first 24 hours postoperatively and every 2-3 hours in the second 24 hours postoperatively, a pain score was documented on only 82% of charts reviewed. In addition, 97% of nurses surveyed reported that they did not use a formal scale to assess pain while also reporting that the FLACC scale, a formal scale, was used on average every 2-3 hours. 44% of nurses reported using behavioral cues reflected in the elements of the FLACC scale to assess pain without applying those cues to the FLACC scale. Conclusions: Nurses' reports of pain assessment practices are not consistent with documentation of pain assessment. Nurses' reported that the FLACC scale was not difficult to use but either did not use it or failed to document the use of the FLACC scale. Implications for nursing: Accuracy of pain assessment remains vital to delivery of quality care to pre-verbal children. This study adds to the body of knowledge about pain assessment practices of pediatric nurses, provides implications for change related to that practice, highlights the importance of staff nurse involvement in clinical research and supports evidence-based practice.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEvidence-based Pain Assessment in Childrenen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155777-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Evidence-based Pain Assessment in Children</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Beoglos, Aris, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Children's Hospital Medical Center of Akron</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">abeoglos@chmca.org</td></tr><tr><td colspan="2" class="item-abstract">Objective: Pain has been identified as the fifth vital sign, signifying the importance of accurate pain assessment and effective pain management for pediatric nurses. A paucity of literature reporting nurses' assessment of pain in the pre-verbal child exists and reliability and validity have not been adequately established in pain assessment tools designed for use in infants and pre-verbal children. The most reliable measure of pain, self report, is not a developmentally appropriate assessment measure for use in the infant and pre-verbal child. As a result, in 1993, the FLACC infant pain assessment tool was adopted by the institution. The FLACC tool utilizes behavioral indicators in pre-verbal children related to Face, Legs, Activity, Cry and Consolability to assign a pain score from 0-10. The purpose of this presentation is to describe: 1) a descriptive survey study of current pain assessment practices of pediatric nurses; and 2) how a collaborative approach can be used to encourage evidence-based clinical practice. Design: Anecdotal reports of nurses' use of individual, subjective criteria to assess pain, rather than using FLACC assessment tool, created an inconsistency in practice that warranted investigation. A descriptive, survey study utilizing retrospective chart review, a survey of current pain assessment practices and focus groups were conducted. Sample: Retrospective chart review of 96 occurrences of infants ages birth -15 months who had undergone cleft lip and/or palate repair from 1997-1999 was performed. A convenience sample of 73 nurses (100% return rate) on the infant unit completed surveys about their pain assessment practices. Additional information was provided by 26 nurses attending 5 focus groups. Variables Studied: Data collected from chart review included demographics, operative procedure performed, hours post operation, associated nursing pain assessment documentation and medications administered for pain relief. A Pain Assessment Questionnaire and a Focus Group Interview Guide provided data from nurses about: 1) how often pain is assessed; 2) tools or behavioral cues used to assess pain; 3) how often the FLACC scale is used; 4) ease of use of the FLACC scale; and 5) why the nurse does or does not use the FLACC scale. Methods: Chart reviews were conducted by nursing staff volunteers to meet requirements of the hospital career ladder. The research team conducted standardized training of data collectors and random inter-rater reliability checks were conducted to ensure consistency of data collection methods. A Pain Assessment Questionnaire was distributed to staff nurses on the infant unit to determine current pain assessment practices. Focus groups with nurses on the infant unit were scheduled on all shifts and provided additional in-depth information about nurses' pain assessment practices. Findings: Only 19% of charts identified the FLACC scale as the pain assessment method used. Similarly, while nurses reported assessing pain every hour in the first 24 hours postoperatively and every 2-3 hours in the second 24 hours postoperatively, a pain score was documented on only 82% of charts reviewed. In addition, 97% of nurses surveyed reported that they did not use a formal scale to assess pain while also reporting that the FLACC scale, a formal scale, was used on average every 2-3 hours. 44% of nurses reported using behavioral cues reflected in the elements of the FLACC scale to assess pain without applying those cues to the FLACC scale. Conclusions: Nurses' reports of pain assessment practices are not consistent with documentation of pain assessment. Nurses' reported that the FLACC scale was not difficult to use but either did not use it or failed to document the use of the FLACC scale. Implications for nursing: Accuracy of pain assessment remains vital to delivery of quality care to pre-verbal children. This study adds to the body of knowledge about pain assessment practices of pediatric nurses, provides implications for change related to that practice, highlights the importance of staff nurse involvement in clinical research and supports evidence-based practice.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T14:09:52Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T14:09:52Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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