Painful procedures were performed frequently and often with inadequate pain management. Unlike neonate clinical factors, organizational factors may be modified to promote a context of care more favourable to pain management.

Analysis 1.3. Comparison 1 Skin-to-skin care versus control, Outcome 3 HRV during painful procedure -Low frequency power..... Analysis 1.4. Comparison 1 Skin-to-skin care versus control, Outcome 4 HRV during painful procedure -High frequency power.... Analysis 1.5. Comparison 1 Skin-to-skin care versus control, Outcome 5 HRV during painful procedure -Low frequency to high frequency ratio.

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Pain processing and management in neonates, especially preterm neonates, differs from older populations. In this review, a brief background on pain processing in neonatal life, pain exposure in Neonatal Intensive Care Units (NICU), the consequences of untreated pain, and the difficulties in treating procedural pain pharmacologically will be presented. A more detailed review of non-pharmacological interventions for procedural pain in neonates will include sensory stimulation approaches, oral sweet solutions, and maternal interventions. Some possible mechanisms for the effectiveness of non-pharmacological interventions are offered. Finally, avenues of research into similar interventions as adjuvant therapies or drug-sparing effects in older populations are suggested.

This is the second of a 2-part series to provide an overview of our current level of knowledge related to nonpharmacological strategies to diminish the pain associated with commonly performed procedures in the NICU. In our first article we discussed the prevalence of repeated pain exposure in the NICU and the importance of nonpharmacological strategies specifically containment or facilitated tucking, swaddling, positioning, nonnutritive sucking, and sweet solutions. These strategies are generally nurse-driven and we believe their importance has been underutilized. In this article we will emphasize the importance of maternal presence as a mediator for pain relief. The efficacy of breastfeeding, maternal skin-to-skin care (often referred to as kangaroo care), and multisensorial stimulation such as auditory and olfactory recognition will be the primary focus of our discussion. In addition, although primarily mother-driven, these strategies are ultimately nurse-enabled, thus the importance of this connection cannot be under appreciated with respect to successful implementation in the NICU.

Nursing education will play an important role in further advancing healthcare transformation in the future. The aim of this study was to assess and compare nursing education and self-reported professional competence among nursing students graduating with a bachelor's degree from higher education institutions in Europe. Data were collected using the Nurse Professional Competence Scale including 88 items and eight competence areas. In total, 752 nursing students at 11 higher education institutions in Europe participated in the study, with a response rate of 88.7%. The highest measured mean scores were found in the competence areas ‘Value-based nursing care’ and ‘Medical technical care’ and the lowest were found in ‘Legislation in nursing and safety planning’ and ‘Education and supervision of staff and students’. Nursing students in central Europe scored significantly higher on seven out of the eight competence areas than nursing students in northern and southern Europe. In order to standardize and further develop nursing education in Europe, the assessment of nursing-related competences is of crucial importance.

Objectives: to evaluate the cognitive learning of nursing students in neonatal clinical evaluation from a blended course with the use of computer and laboratory simulation; to compare the cognitive learning of students in a control and experimental group testing the laboratory simulation; and to assess the extracurricular blended course offered on the clinical assessment of preterm infants, according to the students. Method: a quasi-experimental study with 14 Portuguese students, containing pretest, midterm test and post-test. The technologies offered in the course were serious game e-Baby, instructional software of semiology and semiotechnique, and laboratory simulation. Data collection tools developed for this study were used for the course evaluation and characterization of the students. Nonparametric statistics were used: Mann-Whitney and Wilcoxon. Results: the use of validated digital technologies and laboratory simulation demonstrated a statistically significant difference (p = 0.001) in the learning of the participants. The course was evaluated as very satisfactory for them. The laboratory simulation alone did not represent a significant difference in the learning. Conclusions: the cognitive learning of participants increased significantly. The use of technology can be partly responsible for the course success, showing it to be an important teaching tool for innovation and motivation of learning in healthcare.