The Most Effective Pain Assessment Methods

Paper Summary:

This paper proposes the best pain assessment method for infants in the neonatal ward of a hospital. The paper assumes that the Wong-Baker standard is the comparator, and evaluates several techniques as addressed in a number of clinical studies performed over the past few years. The paper points out that the lack of ability of nurses to consistently judge infant pain can lead to inconsistent application of anti-pain medications, and variability in the amount of pain caused to an infant during necessary procedures. The paper also explains that diagnosis generally precedes therapy in medicine. Good, consistent diagnosis of situations that cause pain can lead to novel methods to reduce that pain. The writer believes that nurses do not intend to be either inaccurate or to judge differently than their fellow nurses.

Outline:
Introduction
The Wong-Baker Pain Scale
Measuring Neonatal Pain is More Difficult
The Need for More Objective Infant Pain Measurement
PIPP: The Most Comprehensive and Complicated Method
Analysis of the PIPP for the Neonatal Ward
CRIES Method to Assess Pain
High Variability Questions Accuracy of PIPP
Conclusion

From the Paper:

"There was an interesting mid-level 'pain' measurement included in the Kritjansen study: movement which should not have caused pain. It was interesting to note that the PIPP score was significantly higher than the resting state, and lower than during the time that the infants should have felt pain. This suggests that the PIPP is measuring more than pain, or conversely that activities like changing diapers cause pain to the baby (probably less likely). Two other limitations of the study should be covered when evaluating PIPP as an indicator of pain: the difficulty of measuring all seven elements in a busy neonatal ward, and the variability between nurses."

Sample of Sources Used:

• American Academy of Pediatrics. (2006). Prevention and management of pain in the neonate: An update. Pediatrics, 118(5), 2231-2241.
• Evans, J. C. (2005). Longitudinal comparison of preterm pain responses to repeated heelsticks. Pediatric Nursing, 31(3), 216-220.
• Jonsdottir, R. B. (2005). The sensitivity of the premature infant pain profile--PIPP--to pain in hospitalized neonates. Journal of Evaluation in Clinical Practice, 11(6), 598-605.
• Reyes, S. (2003). Nursing assessment of infant pain. The Journal of Parinatal & Neonatal Nursing, 17(44), 291-303.
• Thompson, D. G. (2005). Utilizing an oral sucrose solution to minimize neonatal pain. Journal for Specialists in Pediatric Nursing, 10(1), 3-10.

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