Health professionals’ barriers in the management, evaluation, and treatment of neonatal pain

Abstract

BACKGROUND AND OBJECTIVES: Despite the solid results on pain management strategies in neonatology, it is necessary to identify and explore the barriers that may hamper the attention to pain and the implementation of the scientific evidence widely disseminated in the literature in the care practice. The objective of this study was to describe the barriers encountered by the healthcare professionals of a neonatal intensive care unit regarding the management, evaluation, and treatment of newborn pain. METHODS: Descriptive, exploratory, quantitative study carried out in a maternity hospital in the city of Rio de Janeiro. Forty-two nursing technicians, 22 nurses, 20 physicians, and 2 physiotherapists participated in the study. The data was collected in an interview using a form and the data was analyzed by descriptive statistics. RESULTS: Among the barriers found it stands out the lack of training on neonatal pain, no use of scales, the absence of routine and protocols for the treatment of pain, and the need for greater safety for the evaluation and treatment of pain. It was also observed that there is a gap between knowledge and care practice in the unit. CONCLUSION: The identification of these barriers is essential to establish strategies based on knowledge-transfer to overcome the obstacles and improve the care given to newborns in the neonatal intensive care unit.

Percepção do enfermeiro diante da dor no neonato prematuro

“…Existem estudos internacionais e nacionais que avaliaram o conhecimento, as atitudes e práticas dos profissionais de saúde e de enfermagem diante do manejo da dor neonatal, identificaram uma lacuna importante na compreensão de como os mecanismos neurobiológicos são fundamentais e podem interferir no desenvolvimento do sistema nervoso somatossensorial, além da resposta a estímulos potencialmente dolorosos, bem como a avaliação da dor e quais às intervenções não farmacológicas e farmacológicas usadas para aliviar a dor durante os cuidados com o RN (Christoffel et al, 2019).…”

“…Mesmo sabendo das fortes evidências que as intervenções não farmacológicas (como o contato pele a pele, o aleitamento materno, a amamentação e a sucção não nutritiva) trazem ao RN, e que os métodos analgésicos estão disponíveis nas unidades, ainda não estão efetivamente incorporados na prática assistencial das unidades que cuidam de prematuros, quer seja na UTIN quer seja na UCINCo (Christoffel et al, 2019).…”

Barriers of Neonatal Pain Management in the Intensive Care Unit: A Qualitative Study

“…The focus on treating the disease has marginalized pain management. According to the some studies, the lack of routine pain relieving care in NICU is a barrier in pain management (Christoffel et al, 2019;Lago et al, 2013).…”

“…This issue has brought about inconsistencies in providing services, overstimulation of the neonates, and losing opportunities in relieving their pain. Christoffel et al and Razeq et al, pointed out that communication channels between professions need to be improved to perform appropriately against neonate's pain (Christoffel et al, 2019) (Razeq, 2016). Stevens et al also considers inter-professional collaboration as the basis of effective practice on pain in the NICU and states that free participation of all team members, respect for each other's knowledge, joint decisions, and having a common goal to promote clinical outcomes for neonates are necessary for effective inter-professional collaboration (Stevens et al, 2011).…”

“…Al-Braiki in his study, considers the noisy and crowded environment as stressful and believes that such an environment can prevent proper relief of neonate's pain (Al-Braiki, 2019). In another study, a noisy and bright environment was mentioned as a hostile environment that can irritate the neonate and aggravate his pain (Christoffel et al, 2019).…”