The impact of educational intervention programs on pain management in a pediatric emergency department

Augarten, Arie; Zaslansky, Ruth; Matok, Ilan; Minuskin, Tal; Lerner‐Geva, Liat; Hirsh-Yechezkel, Galit; Ziv, Amitai; Shavit, Itai; Yativ, Nir; Keidan, Ilan

doi:10.1016/j.biopha.2006.06.013

Cited by 18 publications

(15 citation statements)

References 12 publications

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“…Pediatrics 2012;130:e1391-e1405 BACKGROUND A systematic approach to pain management is required to ensure relief of pain and anxiety for children who enter into the emergency medical system, which includes all emergency medical services (EMS) agencies, interfacility critical care transport teams, and the emergency department (ED). 1 The administration of appropriate analgesia in children varies by age as well as by training of the ED team (which includes physicians, nurses, physician assistants, and nurse practitioners), however, and still lags behind analgesia provided for adults in similar situations. 2 Furthermore, neonates are at highest risk of receiving inadequate analgesia.…”

mentioning

confidence: 99%

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Zempsky¹,

Cravero²,

Shaw³

et al. 2012

Pediatrics

286

179

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Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child' s and family' s reaction to current and future medical care. A systematic approach to pain management and anxiolysis, including staff education and protocol development, can provide comfort to children in the emergency setting and improve staff and family satisfaction. Pediatrics 2012;130:e1391-e1405 BACKGROUND A systematic approach to pain management is required to ensure relief of pain and anxiety for children who enter into the emergency medical system, which includes all emergency medical services (EMS) agencies, interfacility critical care transport teams, and the emergency department (ED). 1 The administration of appropriate analgesia in children varies by age as well as by training of the ED team (which includes physicians, nurses, physician assistants, and nurse practitioners), however, and still lags behind analgesia provided for adults in similar situations. 2 Furthermore, neonates are at highest risk of receiving inadequate analgesia. 3,4 Encouragingly, improvements in the recognition and treatment of pain in children have led to changes in the approach to pain management for acutely ill and injured pediatric patients. 5 Studies have shown an increase in opiate use in children with fractures. [6][7][8] Recent advances in the approach and support for pediatric analgesia and sedation, as well as new products and devices, have improved the overall climate of the ED for patients and families in search of the "ouchless" ED. 5,9 Increased parental education regarding pain and sedation, physician comfort and desire to enhance patient satisfaction, and a quest to satisfy accreditation regulations have appropriately driven this effort. System-wide approaches for pain management awareness and strategies work best if they are woven into the fabric of the emergency medical system through education and protocol development. The purpose of this report was to provide information to optimize the comfort and minimize the distress of children and families as they are cared for in the emergency setting.

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mentioning

confidence: 99%

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Zempsky¹,

Cravero²,

Shaw³

et al. 2012

Pediatrics

286

179

View full text Add to dashboard Cite

show abstract

“…Respondent demographic data are shown in Table 1. Male sex, n (%) 0 (0) 4 (17) 19 (25) 23 (18) .009 Age, mean (SD), y 43 (9) 43 (10) 38 (8) 40 (9) .007 Nursing experience, mean (SD), y 21 (9) 18 (11) 14 (9) 14 (10) .006 Pediatric nursing experience, mean (SD), y 19 (9) 16 (10) 11 (8) 13 (9) b .001 Triage experience, mean (SD), y 11 (9) 10 (7) 7 (7) 9 (8) .047…”

Section: Resultsmentioning

confidence: 99%

“…[6][7][8] Patients may have pain from an underlying illness or injury, as well as from necessary medical procedures such as venipuncture or fracture reduction. 8,9 A large multicenter study found that only 60% of patients with moderate to severe pain receive any analgesia in the emergency department. 10 Unfortunately, oligoanalgesia (under-treatment of pain) remains a welldocumented problem in the ED setting.…”

mentioning

confidence: 99%

Pediatric Pain Management in the Emergency Department: The Triage Nurses’ Perspective

Thomas¹,

Kircher²,

Plint³

et al. 2015

Journal of Emergency Nursing

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“…Research findings support that the implementation of educational programs and procedural pain management protocols in the ED improved the quality of care (Augarten et al, 2006; were contingent on the treatment of procedural pain as a priority, and the development of multidisciplinary committees with administrative authority to mandate change (MeunierSham & Ryan, 2003;Schechter, 2008). Contrary to those results some researchers found pain management programs to be less effective for the improvement of procedural pain management and pain documentation (Ellis et al, 2007).…”

Section: Environmental Issues and Policies In The Edmentioning

confidence: 85%

An Ethnography of the Culture of Pain in a Non-Pediatric Emergency Department

Cummings¹

2013

Journal of Pediatric Health Care

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Rationale for the Study: Despite the exponential growth in pharmacological and nonpharmacological methods for the treatment of pediatric procedural pain there remains a gap between available interventions and actual practice in the emergency department clinical setting. Researchers have recommended the examination of unit culture since culture is proposed to be a major factor that affects the implementation of pain management practices. Method:Ethnography was employed to gain access to the beliefs and practices of healthcare participants in a Northeastern non-pediatric emergency department. Data were collected for 5 months with over 100 hours of observation. Six key informants were interviewed and 44 pediatric procedural interactions with 27 healthcare providers during the treatment of children two to eight years of age undergoing procedures were observed.Other information gathered included documents from the institution, and pain related information from the patient's medical record. All interviews were recorded and transcribed verbatim. Data were managed using the Ethnograph 6.0 and analyzed using the procedure developed by Leininger and McFarland (2006). Results:Seven major themes with categories were discovered that included assessment, ii procedural pain, treatment of pain, communication related to comfort, fragmentation of care in the emergency department, healthcare provider attitudes, and environmental issues and policies. Conclusion:The results of this study suggest that practice environment of the emergency department and organizational culture exerted a significant degree of influence over healthcare providers' pediatric pain management practices. Nurses' did not use pain measurement tools as they were intended to be used and instead improvised measurement by observing the child's behavior. The management of children during painful procedures consisted of an array of behaviors and practices. The use of physical restraint during painful procedures was a common practice. Participants continue to hold many assumptions and misconceptions about pediatric pain assessment and management. The findings of this study provide insight to the everyday practice of emergency department healthcare providers for pediatric pain in a non-pediatric setting.iii Acknowledgments and Dedication

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The impact of educational intervention programs on pain management in a pediatric emergency department

Cited by 18 publications

References 12 publications

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Pediatric Pain Management in the Emergency Department: The Triage Nurses’ Perspective

An Ethnography of the Culture of Pain in a Non-Pediatric Emergency Department

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