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Procedural pain in neonates in Australian hospitals: A survey update of practices

Authors

  • Jann Foster,

    Corresponding author
    1. Central Clinical School – Discipline of Obstetrics and Gynaecology, University of Sydney
    2. Sydney Nursing School, University of Sydney
    • School of Nursing and Midwifery, University of Western Sydney
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  • Kaye Spence,

    1. Grace Centre for Newborn Care, Sydney Children's Hospitals Network, Sydney, New South Wales
    2. School of Nursing and Midwifery, Queens University, Belfast, Northern Ireland
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  • David Henderson-Smart,

    1. Central Clinical School – Discipline of Obstetrics and Gynaecology, University of Sydney
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  • Denise Harrison,

    1. Critical Care and Neurosciences, Murdoch Children's Research Institute
    2. Faculty of Medicine, Dentistry and Health Children's, The University of Melbourne, Melbourne, Victoria
    3. Children's Hospital of Eastern Ontario (CHEO) Research Institute
    4. Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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  • Peter H Gray,

    1. Newborn Services, Mater Mothers' Hospital, Brisbane, Queensland, Australia
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  • John Bidewell

    1. School of Science and Health, University of Western Sydney
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  • Declaration of conflict of interest: None.

Correspondence: Dr Jann Foster, Centre for Perinatal Health Services Research, University of Sydney, City Road, Sydney, NSW 2005, Australia. Fax: 93517742; email: j.foster@bigpond.net.au

Abstract

Aim

The study aims to determine whether there has been improved uptake of the evidence for the management of procedural pain in neonates throughout Australia.

Methods

An Australian-wide survey was undertaken to determine the use of breastfeeding and sucrose and whether a clinical practice guideline (CPG) or pain assessment tool was used.

Results

Data were available from 196 (91%) of the 215 eligible hospitals. A CPG informed the management of neonatal pain in 76 (39%) of the hospitals. There was wide variation in their use between the states, and a significantly higher use of a CPG in higher-level care units. A pain assessment tool was only used in 21 (11%) of the units with greater use in the higher level care neonatal intensive care units (50%) and surgical neonatal intensive care units (80%). Awareness of breastfeeding for procedural pain was reported by 90% of the 196 respondents while 78% reported that it was actually used. Awareness of sucrose for procedural pain was lower than breastfeeding at 79%, with 53% reporting that they used sucrose in their unit. Overall, 89% of the respondents reported that either breastfeeding or sucrose was used for the management of procedural pain in their units.

Conclusion

There has been an increase in awareness and use of sucrose and breastfeeding for procedural pain in Australia since previous surveys were undertaken in 2004. Continued resources, local pain champions and a national interest group to promote the use of pain management for procedural pain in neonates are needed for continued uptake of the evidence.

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