Inadequate Pediatric Procedural Pain Management in the Emergency Room: A Policy Analysis

Abstract

Purpose: Within the provisions of the Patient Protection and Affordable Care Act (PPACA) are specific guidelines on advancing science related to patient pain outcomes. Invasive painful procedures are a common part of pediatric nursing. Many children experience unrelieved procedural pain while in the emergency or urgent care setting. In this paper the following health policy issue is analyzed: underutilization of pain and comfort management in the emergency care setting among children during painful procedures. Design and methods: Using a formal policy analysis method, consideration of: criteria, related factors, and key stakeholders were completed. A proposal for adopting evidence-based clinical practice guidelines was made. This recommendation was evaluated with four essential criteria including: cost, effectiveness, timeliness, and administrative ease. Findings: Political, social, economic, and ethical factors exist which affect the issues of inadequate pediatric procedural pain and comfort management in emergency care. Evidence suggests implementation of an institutional policy change or a unit/department-based protocol will improve nurse utilization of procedural pain treatments. Conclusion: The issue of inadequate pediatric procedural pain management in emergency departments can be appropriately addressed by institutional implementation of evidence-based practice and policy guidelines. This action has been shown to increase nursing adherence with procedural pain management and improve child procedural pain outcomes. Clinical relevance: Increasing nursing utilization of pediatric procedural pain treatment through policy implementation will improve child health and overall quality of life.