Comfort Scale: A Reliable and Valid Method to Measure the Amount of Stress of Ventilated Preterm Infants

Wielenga, Joke M.; Vos, R. de; Leeuw, R. de; Haan, Rob J. de

doi:10.1891/0730-0832.23.2.39

Cited by 32 publications

(32 citation statements)

References 9 publications

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“…We chose the COMFORT scale over other multidimensional PAD scales, because it has been validated for use in newborns to assess objectively the adequacy of analgesia/sedation and it is widely used [13,19,31]. However, as opposed to the situation for adults, no scale is currently able to distinguish pain from discomfort in newborns [32,33].…”

Section: Discussionmentioning

confidence: 99%

“…The sum of the different items ranges from 8 to 40. Different cutoff or range values for the COMFORT scale have been proposed or established to describe the infant’s status in terms of pain and discomfort [13,14]. On our unit, we follow the recommendations of the Centre National de Ressources de lutte contre la douleur (CNED; National Center for Resources to Combat Pain; http://www.pediadol.org/IMG/pdf/COMFORT.pdf).…”

Section: Methodsmentioning

confidence: 99%

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Implementation of a neonatal pain management module in the computerized physician order entry system

Mazars

Milési

Carbajal

et al. 2012

Ann. Intensive Care

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BackgroundDespite the recommended guidelines, the neonatal management of pain and discomfort often remains inadequate. The purpose of the present study was to determine whether adding a pain and discomfort module to a computerized physician order entry (CPOE) system would improve pain and discomfort evaluation in premature newborns under invasive ventilation.MethodsAll newborns <37 weeks gestational age (GA) and requiring invasive ventilation were included in a prospective study during two 6-month periods: before and after the inclusion of the pain and discomfort evaluation module. The main outcome measure was the percentage of patients having at least one assessment of pain and discomfort per day of invasive ventilation using the COMFORT scale.ResultsA total of 122 patients were included: 53 before and 69 after the incorporation of the module. The mean age was 30 (3) weeks GA. After the module was included, the percentage of patients who benefited from at least one pain and discomfort assessment per day increased from 64% to 88% (p < 0.01), and the mean number (SD) of scores recorded per day increased from 1 (1) to 3 (1) (p < 0.01). When the score was not within the established range, the nursing staff adapted analgesia/sedation doses more frequently after module inclusion (53% vs. 34%, p < 0.001). Despite higher mean doses of midazolam after module introduction [47 (45) vs. 31 (18) μg/kg/hr, p < 0.05], the durations of invasive ventilation and hospital stay, and the number of nosocomial infections, were not significantly modified.ConclusionsAdding a pain and discomfort tool to the CPOE system was a simple and effective way to improve the systematic evaluation of premature newborns who required ventilatory assistance.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Implementation of a neonatal pain management module in the computerized physician order entry system

Mazars

Milési

Carbajal

et al. 2012

Ann. Intensive Care

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“…Reliability and validity of the COMFORT Scale has been established with postoperative infants to age three (van Dijk et al, 2000), ventilated preterm infants (Wielenga & de Leeuw, 2004), and children through adolescence in the Pediatric Intensive Care Unit (Ambuel et al, 1992). Reliability and validity of the FACES Pain Rating Scale developed by Wong and Baker (1988) has been established with verbal children over the age of four and with three year olds who are able to count and can demonstrate understanding of the tool (Keck et al, 1996).…”

Section: Methodsmentioning

confidence: 99%

Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients

Schell

Briening

Lebet

et al. 2011

Journal of Pediatric Nursing

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The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences. BPs were measured simultaneously using bedside and portable Spacelabs monitors. Calf BPs were greater than arm BPs in approximately 73% of the sample. Paired t tests show statistically significant differences for systolic BPs and mean arterial pressures. Influence of demographics, agitation levels, medical diagnoses, and current medications was explored. Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years.

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“…The point of view of the patients is, thus, clinically relevant, because better patient well-being is related to a better treatment compliance [9,59,60], a critical issue in home ventilation especially in those undergoing NIV. However, data available Choosing a ventilator for home mechanical ventilation about patient satisfaction regarding mechanical ventilation are very scarce [5,61]. There are perceived differences between ventilators, but there is no ''perfect ventilator'' [9].…”

Section: The Patient's Point Of Viewmentioning

confidence: 99%

Choosing a ventilator for home mechanical ventilation

Gregoretti¹,

Navalesi

S³

et al. 2013

Breathe

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Comfort Scale: A Reliable and Valid Method to Measure the Amount of Stress of Ventilated Preterm Infants

Abstract: In this first evaluation, the COMFORT scale appears to be a valid and reliable measurement tool to assess the stress of ventilated prematurely born babies.

Cited by 32 publications

References 9 publications

Implementation of a neonatal pain management module in the computerized physician order entry system

Implementation of a neonatal pain management module in the computerized physician order entry system

Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients

Choosing a ventilator for home mechanical ventilation

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