Why should you care?
The Help PaiN-Pass Quality Improvement project in the neonatal intensive care unit (NICU) is part of our commitment to pain management for newborns. It supports our pledge to provide parents the most accurate information possible to help them make informed decisions about their child's medical care.
- The Goal - The NICU staff use the Neonatal Pain and Sedation Scale (N-PASS) scoring system to assess and reassess the pain of all babies from admission through discharge in the NICU. The goal is to: (1) recognize pain, (2) provide interventions to treat or ease the pain, and (3) help babies become comfortable while ill.
- The Process - An assessment of pain levels begins as soon as the baby arrives in the NICU. Staff will continue to monitor the baby's pain throughout their stay in the hospital. Because babies cannot express pain in words, the NICU uses the N-PASS to determine the pain level. It consists of five areas of behavioral and physiological data scored on a scale from zero to 10. Pain management interventions commonly used to ease and control pain:
- Comfort holding
- Minimizing stimulation
- Dispensing sucrose (concentrated sugar)
- Offering a pacifier
- Decreasing lights and noise
- Giving medication
Who is impacted?
- Babies - Babies in the NICU can experience pain just like adults. In fact, research shows that premature babies are even more sensitive to pain than adults. Some infants may be too sick to clearly show signs of pain.
- Parents - Research shows that concerns about infant pain are a major factor in stress level for parents, says Dr. Pallotto. Reducing pain can reduce parents stress.
- Our staff - We especially want parents to understand that we are thinking about pain and pain management for their babies, says Barb Haney, Clinical Nurse Specialist and ECMO Coordinator.
What does this all mean?
Paying special attention to pain management helps ease at least one source of worry during a highly stressful time for parents. This stress can be reduced when parents are included, educated and informed about the care we are providing their baby.
We provide our families with tools and resources, such as A Guide to Pain Management in Infants, to help them understand the process, signs of pain and comfort methods.
We closely monitor our documentation rates, which allow nurses to see their adherence over time. The chart [below] shows the pain assessment rate when a child is admitted into our NICU. The slight decrease in the chart is a direct effect of the implementation of a new nursing charting system. This change uses different triggers for completion of charting and tasks.
Where can I go for more information?
Visit our NICU page to learn more.
Our focus on pain has lead to new ways of caring for your child, which aim to limit the risk of side effects commonly associated with sedation medication. Read an example of limiting this risk in neonates needing an MRI.