Reyes, S. (2003).Journal of Perinatal and Neonatal Nursing,17 (4), 291-303.
While most neonatal intensive care (NICU) nurses recognize the need for adequate, consistent, and frequent assessment of infant pain, most will also agree that infant pain assessment is a challenge. Reasons for this recently cited in the literature include that infants are incapable of verbalizing their pain, often do not sustain painful expressions, and that their pain presents in a variety of behavioral responses (Abu-Saad, Bours, Stevens, & Hamers, 1998;Fuller & Conner, 1995). Additionally, many nurses have not been educated about infant pain and nursing pain assessments (Fuller, 1998). This study compared 24 NICU nurses' beliefs about infant pain and pain assessment with their actual practices as documented by a retrospective review of 107 infant records. Results from a researcher-developed survey that was tested for face and content validity revealed that between 50 and 90% of nurses surveyed agreed that infant pain is often unrecognizable, infants' responses to pain are very individualized, nurses accurately assess infant pain, the use of a standardized infant pain assessment tool is effective in assessing infant pain, and that documentation of infant pain is related to more effective pain relief. Yet, while more than 90% of the nurses believed that infant pain assessment is important, 62% of infant records on the day shift and 56.2% of evening records had no pain assessments documented. Fewer than 10% of infants who had experienced arterial puncture, PICC line, or CT placement had received pain assessments. This study supports the recommendations of the Joint Commission on Healthcare Organizations Pain Standards and the American Academy of Pediatrics for standardized infant pain assessment, prevention, and management.
Comment by Judy A. Beal
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