2.50
Hdl Handle:
http://hdl.handle.net/10755/616249
Category:
Full-text
Type:
Presentation
Title:
The Prevalence and Management of Pain in Pediatric Intensive Care Units
Other Titles:
Symposium: Pediatric Pain Management in Unique Populations and Settings
Author(s):
LaFond, Cynthia
Lead Author STTI Affiliation:
Non-member
Author Details:
Cynthia LaFond, RN, CCRN, Cynthia.LaFond@uchospitals.edu
Abstract:
Session presented on Sunday, July 24, 2016: Purpose: The purpose of this multi-site study is to describe the frequency and characteristics of pain experienced by critically ill children and the pain management practices provided to them during a 24-hour time period. Though current research points to a problem of pain in PICUs, there is still much that is not well understood. Prior research has been limited in scope, evaluating pain in PICU sub-populations (Bai & Hsu, 2013; Grant, Scoppettuolo, Wypij, Curley, & Team, 2012) or a particular type of pain (e.g. pain from procedures or pain rated as moderate to severe) (Agarwal et al., 2010; Groenewald, Rabbitts, Schroeder, & Harrison, 2012; Larsen, Donaldson, Parker, & Grant, 2007; Stevens et al., 2011). Prevalence studies, which measure the proportion of the population with a condition such as pain, can provide insight into the problem. Yet, pediatric pain prevalence studies in North America have either excluded PICU patients (Ellis et al., 2002) or report few unit-specific results (Groenewald et al., 2012; Stevens et al., 2012; Taylor, Boyer, & Campbell, 2008). As a result of these gaps in the literature, it is not clear under which circumstances critically ill children are at greatest risk for pain. A more comprehensive evaluation of the pain critically ill children experience and the practices surrounding their pain, such as pain assessments and pharmacological and non-pharmacological interventions is needed. Methods: For this point-prevalence study, the health records of children admitted to PICUs across four US children?s hospitals/units during a 24-hour time period were reviewed. Data were collected regarding pain assessments, pharmacological and non-pharmacological pain interventions, and painful procedures documented during the 24 hours. Results: The records of 77 children were reviewed. Patients ranged in age from 1 month to 25 years old, and were more often male (N = 42, 54.5%), and Caucasian (N = 40, 53.3%). The majority of patients were admitted to the PICU for medical reasons (N = 61, 79.2%) versus surgical reasons (N = 11, 14.3%). PICU length of stay ranged from 1 to 752 days (median 7, mode 2); 39% of patients were mechanically ventilated at the time of the study. Pain assessments were conducted on average 10 times (SD 4.6) during the 24 hours (range 2 to 28), most often using a behavioral pain scale (N = 605, 79%). Pain was present in 14% of assessments (M = 0.6, SD 1.6). Pain quality was infrequently documented (N = 6, 6%). Pain location was recorded 25% (N = 25) and pain etiology 36% (N = 37) of the time. Pharmacological interventions were provided to 59 (77%) patients; most often (64%) opioid analgesics were provided. Non-pharmacological interventions were provided to 51% of patients. The most commonly documented non-pharmacological interventions included decreasing environmental stimuli, caregiver/parent presence, and repositioning. Nearly all (N = 65, 84%) patients received a potentially painful procedure (range 0 to 31); more than half of these procedures included suctioning of the airway. Conclusion: This study begins to fill a gap in the literature regarding the prevalence of and practices surrounding pain for critically ill children in the United States. Results begin to inform future research and interventions to improve practice.
Keywords:
Children; Pain; PICU
Repository Posting Date:
13-Jul-2016
Date of Publication:
13-Jul-2016 ; 13-Jul-2016
Other Identifiers:
INRC16J01; INRC16J01
Conference Date:
2016
Conference Name:
27th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Cape Town, South Africa
Description:
Theme: Leading Global Research: Advancing Practice, Advocacy, and Policy

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleThe Prevalence and Management of Pain in Pediatric Intensive Care Unitsen
dc.title.alternativeSymposium: Pediatric Pain Management in Unique Populations and Settingsen
dc.contributor.authorLaFond, Cynthiaen
dc.contributor.departmentNon-memberen
dc.author.detailsCynthia LaFond, RN, CCRN, Cynthia.LaFond@uchospitals.eduen
dc.identifier.urihttp://hdl.handle.net/10755/616249-
dc.description.abstractSession presented on Sunday, July 24, 2016: Purpose: The purpose of this multi-site study is to describe the frequency and characteristics of pain experienced by critically ill children and the pain management practices provided to them during a 24-hour time period. Though current research points to a problem of pain in PICUs, there is still much that is not well understood. Prior research has been limited in scope, evaluating pain in PICU sub-populations (Bai & Hsu, 2013; Grant, Scoppettuolo, Wypij, Curley, & Team, 2012) or a particular type of pain (e.g. pain from procedures or pain rated as moderate to severe) (Agarwal et al., 2010; Groenewald, Rabbitts, Schroeder, & Harrison, 2012; Larsen, Donaldson, Parker, & Grant, 2007; Stevens et al., 2011). Prevalence studies, which measure the proportion of the population with a condition such as pain, can provide insight into the problem. Yet, pediatric pain prevalence studies in North America have either excluded PICU patients (Ellis et al., 2002) or report few unit-specific results (Groenewald et al., 2012; Stevens et al., 2012; Taylor, Boyer, & Campbell, 2008). As a result of these gaps in the literature, it is not clear under which circumstances critically ill children are at greatest risk for pain. A more comprehensive evaluation of the pain critically ill children experience and the practices surrounding their pain, such as pain assessments and pharmacological and non-pharmacological interventions is needed. Methods: For this point-prevalence study, the health records of children admitted to PICUs across four US children?s hospitals/units during a 24-hour time period were reviewed. Data were collected regarding pain assessments, pharmacological and non-pharmacological pain interventions, and painful procedures documented during the 24 hours. Results: The records of 77 children were reviewed. Patients ranged in age from 1 month to 25 years old, and were more often male (N = 42, 54.5%), and Caucasian (N = 40, 53.3%). The majority of patients were admitted to the PICU for medical reasons (N = 61, 79.2%) versus surgical reasons (N = 11, 14.3%). PICU length of stay ranged from 1 to 752 days (median 7, mode 2); 39% of patients were mechanically ventilated at the time of the study. Pain assessments were conducted on average 10 times (SD 4.6) during the 24 hours (range 2 to 28), most often using a behavioral pain scale (N = 605, 79%). Pain was present in 14% of assessments (M = 0.6, SD 1.6). Pain quality was infrequently documented (N = 6, 6%). Pain location was recorded 25% (N = 25) and pain etiology 36% (N = 37) of the time. Pharmacological interventions were provided to 59 (77%) patients; most often (64%) opioid analgesics were provided. Non-pharmacological interventions were provided to 51% of patients. The most commonly documented non-pharmacological interventions included decreasing environmental stimuli, caregiver/parent presence, and repositioning. Nearly all (N = 65, 84%) patients received a potentially painful procedure (range 0 to 31); more than half of these procedures included suctioning of the airway. Conclusion: This study begins to fill a gap in the literature regarding the prevalence of and practices surrounding pain for critically ill children in the United States. Results begin to inform future research and interventions to improve practice.en
dc.subjectChildrenen
dc.subjectPainen
dc.subjectPICUen
dc.date.available2016-07-13T11:08:06Z-
dc.date.issued2016-07-13-
dc.date.issued2016-07-13en
dc.date.accessioned2016-07-13T11:08:06Z-
dc.conference.date2016en
dc.conference.name27th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationCape Town, South Africaen
dc.descriptionTheme: Leading Global Research: Advancing Practice, Advocacy, and Policyen
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