Original ArticleA Cross-Sectional Review of Pain Management Interventions Used for Painful Pediatric Blood Draw Procedures in Hospital
Section snippets
Design
This study was cross-sectional and used two data sources. Data were collected using chart reviews and brief interviews conducted at the bedside of children. Interviews were conducted with children and/or the caregivers of children when children were unable or unwilling to self-report.
Setting and Sample
The setting was a single 14-bed inpatient pediatrics unit at a southeastern Ontario hospital. This hospital serviced a catchment area of over 20,000 square kilometers, including many northern rural communities, and
Sample & Demographic Characteristics
Data collection occurred between May 16 and June 5, 2019. Seventy-six children were screened over these 21 days. Of the 58 potential participants approached, eight (14%) refused to participate leaving a sample of 50 children included in this study (see Figure 1 for participant flow chart). There were slightly more males (n = 26, 52%) than females. The mean age was 7.06 ± 5.53 years. Children had been admitted for a median of one day (IQR = 1) at the time of the interview. The majority of
Discussion
More than two-thirds of the 50 children in this sample had undergone at least one painful procedure for bloodwork during their current admission at the time of the study. The most common painful procedures previously reported for children were peripheral IV cannulation, venipuncture, and heel sticks (Ellis et al., 2004; Harrison et al., 2014; Stevens et al., 2011). The findings from this study were no exception as these three procedures represented over 90% of the participants’ most recent
Conclusion
Findings demonstrate that procedural pain was undertreated when compared with an existing practice guideline despite the abundance of high-quality evidence, readily available PPM interventions, and existing published literature surrounding PPM. Despite these findings, both intervention effectiveness, as perceived by children and caregivers, and child-caregiver satisfaction with pain management were found to be relatively high. The development of local pain management policies, practice
Conflict of Interest
None.
Acknowledgements
We thank the infants, children, and caregivers who participated in this study, as well as the staff and unit manager for their cooperation and support with this study.
References (32)
- et al.
Parents’ perceived satisfaction of care, communication and environment of the Pediatrics Intensive Care Units at a tertiary children's hospital
Journal of Pediatric Nursing
(2016) - et al.
Distraction kits for pain management of children undergoing painful procedures in the Emergency Department: A pilot study
Pain Management Nursing
(2017) - et al.
The continuum of patient satisfaction: From satisfied to very satisfied
Social Science and Medicine
(2003) - et al.
Selling comfort: A survey of interventions for needle procedures in a pediatric hospital
Pain Management Nursing
(2004) - et al.
Documentation of bronchoscopic procedures: Templates are an effective way to improve documentation and audit of bronchoscopic procedures
Chest
(2012) - et al.
Parental holding and positioning to decrease IV distress in young children: A randomized controlled trial
Journal of Pediatric Nursing
(2007) - et al.
Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review)
Cochrane Database of Systematic Reviews
(2018) - et al.
Parents’ positioning and distracting children during venipuncture
Journal of Holistic Nursing
(2004) - et al.
Order sets in health care: A systematic review of their effects
International Journal of Technology Assessment in Health Care
(2012) - et al.
Pain management strategies used during early childhood immunisation in Victoria
Journal of Paediatrics and Child Health
(2013)
Pain prevalence in a pediatric hospital: Raising awareness during Pain Awareness Week
Pain Research and Management
Be sweet to toddlers during needles: Pilot randomized controlled trial of sucrose compared to placebo
Nursing Reports
Breastfeeding for procedural pain in infants beyond the neonatal period (Review)
Cochrane Database of Systematic Reviews
Too many crying babies: A systematic review of pain management practices during immunizations on YouTube
Bio Med Central Pediatrics
Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years
Cochrane Database of Systematic Reviews
Adapting clinical practice guidelines to local context and assessing barriers to their use
Canadian Medical Association Journal
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Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6–8 years: A randomized experimental study
2022, Journal of Pediatric NursingCitation Excerpt :The children's pain, anxiety, and fear associated with invasive procedures can be affected by age, temperament, previous hospitalization experiences, cultural and developmental characteristics. During hospitalization, children experience pain most frequently due to venipuncture, heel-stick sampling, and peripheral IV placement (Chen et al., 2021; Harrison et al., 2014; Revell et al., 2021). Pain that cannot be managed effectively in children may result in the activation of the hypothalamic-pituitary-adrenal (HPA) axis, prolonged hospitalization, needle phobia, anxiety, sleep problems, and avoidance of healthcare procedures (Bradford et al., 2019).