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Nurse ‘champions’ linked to better neonatal pain monitoring

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Having a nurse “champion” to enhance care in neonatal units is linked with an increased likelihood of patients being monitored for continuous pain, according to researchers.

They found intensive care units with nursing champions, local pain management guidelines and higher surgical admissions performed assessments of continuous pain more frequently than others.

“We need to develop better ways for monitoring pain in newborn babies”

Kanwaljeet Anand

Overall, however, the investigators found that only 31.8% of newborns in their study were assessed for prolonged, continuous pain.

Daily assessments of continuous pain occurred in only 10.4% of newborns, they said in the journal Acta Paediatrica.

The analysis involved 243 neonatal intensive care units from 18 European countries, and 6,648 newborns.

The researchers, from the EUROPAIN survey working group of the NeoOpioid Consortium, included Elaine Boyle, a senior lecturer in neonatal medicine at the University of Leicester.

They recorded frequency of pain assessments, use of mechanical ventilation, sedation, analgesia, or neuromuscular blockade for each neonate up to 28 days after neonatal intensive care admission.

“Assessments of continuous pain occurred in less than one-third of NICU admissions, and daily in only 10% of neonates,” stated the study authors.

“NICU clinical practices should consider including routine assessments of continuous pain in newborns, said the researchers.

Lead study author Dr Kanwaljeet Anand, from Stanford University School of Medicine in California, said: “A lot of these babies are exposed to prolonged pain caused by surgical operations, repeated invasive procedures, or inflammatory diseases.

“In the absence of frequent assessments, I’m concerned that many babies may be under-treated or over-treated for painful conditions,” he said.

“We need to develop better ways for monitoring pain in newborn babies,” he added.

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