Pain Assessment and Management Practices via Education & Reinforcement (PAMPER): A Quality Improvement Initiative

Objectives To establish neonatal pain management practices as an essential developmental supportive measure at a tertiary care unit. Methods This quality improvement initiative was conducted as per Point-of-Care-Quality-Improvement Model over 6 mo, followed by 2 y of sustenance phase at a Neonatal I...

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Bibliographic Details
Published in:Indian journal of pediatrics 2024-09, Vol.91 (9), p.899-905
Main Authors: Upadhyay, Jaya, Soni, Shishir, Shubham, Shantanu, Kumar, Sourabh, Singh, Poonam, Basu, Sriparna
Format: Article
Language:English
Subjects:
Gynecology
Medicine
Medicine & Public Health
Original Article
Pediatrics
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Summary:Objectives To establish neonatal pain management practices as an essential developmental supportive measure at a tertiary care unit. Methods This quality improvement initiative was conducted as per Point-of-Care-Quality-Improvement Model over 6 mo, followed by 2 y of sustenance phase at a Neonatal Intensive Care Unit (NICU) in northern India. Infants of birth weight ≤1800 g were included and assessed for pain. P ain A ssessment and M anagement P ractices via E ducation and R einforcement (PAMPER) group was created by resident doctors and nursing staff. The Premature Infant Pain Profile score was used for the assessment of pain. Limiting factors were analyzed using a fishbone diagram and interventions were done in multiple Plan-Do-Study-Act cycles. Results At the end of interventions, 100% of procedures were assessed for pain. The mean (standard deviation) documented pain score for the first seven days was reduced from 12.8 (0.3) in the baseline phase to 7 (2.5). These interventions helped to sustain the practice in >70% of infants in the next 2 y. Conclusions Low-cost interventions improved the pain assessment and management policy of authors’ NICU with the establishment of a standard protocol. Audits and reinforcement at regular intervals helped in its long-term sustenance.
ISSN:0019-5456
0973-7693
0973-7693
DOI:10.1007/s12098-023-04863-8