Original Article
Time for Action: Understanding Health Care Professionals Views on Pain and Pain Management in a Pediatric Hospital

https://doi.org/10.1016/j.pmn.2022.10.002Get rights and content

Background

Children admitted to the hospital experience pain. ChildKind International (CKI) is an organization dedicated to improving the quality of pediatric pain care worldwide. In 2019, BC Children hospital (BCCH) clinicians set out to achieve this certification. A qualitative study was performed in order to fully comprehend the current state of pain assessment and management at BCCH.

Aim

The objective of this study is to characterize the perceptions of health care professionals (HCPs) about pediatric pain and pain management in a pediatric hospital.

Methods

We choose a quantitative methodology as it allows us to delve more deeply into the HCPs’ personal experience with pain and pain management of children in the hospital. We interviewed 31 pediatric healthcare professionals (N = 31).

Results

HCPs believe there is a significant lack of resources, especially educational resources, to adequately assess and treat pain in children. There is a lack of time to evaluate each patient appropriately and use pain tools consistently for both verbal and non-verbal children. HCPs varied in their opinions as to whether a procedure is painful or uncomfortable, and this opinion often differs from the perception of the child. Additionally, staff recognize that cultural diversity of both staff and patients can influence pain assessment and management in children. Therefore, there is a need for increased cultural diversity training for staff.

Conclusions

Pain management and treatment of children in the hospital remain inconsistent and inadequate. ChildKind certification will help hospitals to address this gap in their clinical practice.

Section snippets

Objective of Research Project

Consistent evaluation of pain assessment and management practices and goals in an institution is essential for successfully responding to patient needs and offering high-quality, comfort-oriented care. The primary objective of this study was to understand the perceptions of HCPs with respect to pediatric pain assessment and pain management at a tertiary pediatric hospital in Western Canada.

Descriptive Data

Our final sample consisted of a diverse range of clinical professions and expertise. A full breakdown of participant demographics is reported in Figure 2.

Staff ranged in age from 24 to 68 years, with 10% identifying as male and 90% identifying as female. Over 45% of participants has at least 15 years’ experience in pediatrics (Fig. 3)

ID analysis revealed a number of common themes. Participants described pain as both a physical and psychological/emotional experience and that pain was subjective,

Discussion

Staff identified a lack of access to relevant personnel (such as pain team) as one factor that limits both the quality of patient interaction and the frequency with which pain assessment occurs. Staff described that when additional referrals or resources are needed to assist with the assessment and treatment of pain these delays are often associated with delayed pain control. While the hospital has pain specialist teams, including an acute pain service and a complex pain service clinic, these

Conclusion

Our findings indicate that it is critical for health care professionals to have a congruent foundational understanding about pain care in order to achieve consistent, evidence-based practices around pain assessment and management. There is an institutional responsibility, to understand how health care practitioners are being educated on pain assessment and management and to encourage inter-disciplinary approaches to education on this issue. Foundational knowledge about pain and the importance

Acknowledgments

Dr. Paula Mahon is a Clinical Nurse Scientist supporting the BCCH Integrated Pain and ChildKind quality improvement projects funded through the BCCH foundation.

We would like to thank our participants for their time and insight. Thanks to Dr. Tim Oberlander for his support. Also, thanks to Mr. Jeremy Plonkowski and Mr. Chinmay Gandhi for their support with transcription.

Declaration of Competing Interest

The authors of this manuscript all contributed substantially to the conception and design of the study, acquisition of data,

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