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dc.contributor.authorTreadgold, R
dc.contributor.authorBoon, D
dc.contributor.authorSquires, P
dc.contributor.authorCourtman, S
dc.contributor.authorEndacott, R
dc.date.accessioned2019-04-05T21:03:13Z
dc.date.issued2019-03
dc.identifier.issn0965-2302
dc.identifier.issn1878-013X
dc.identifier.urihttp://hdl.handle.net/10026.1/13673
dc.description.abstract

INTRODUCTION: Pain management in children is often poorly executed in Emergency Departments and Minor Injury Units. The aim of this study was to assess the impact of a care bundle comprising targeted education on pain score documentation and provision of appropriately dosed analgesia for the paediatric population attending Emergency Departments (EDs) and Minor Injury Units (MIUs). METHODS: A total of 29 centres - 5 EDs and 24 MIUs - participated in an intervention study initiated by Emergency Nurse Practitioners to improve paediatric pain management. In Phase 1, up to 50 consecutive records of children under 18 presenting at each MIU and ED were examined (n = 1201 records); Pain Score (PS), age, whether the child was weighed, and provision of analgesia was recorded. A care bundle consisting of an education programme, paediatric dosage chart and flyers, was then introduced across the 29 centres. Nine months following introduction of the care bundle, the same data set was collected from units (Phase 2, n = 1090 records). RESULTS: The likelihood of children having a pain score documented increased significantly in Phase 2 (OR 6.90, 95% CI 5.72-8.32), The likelihood of children receiving analgesia also increased (OR1.82, 95% CI 1.51-2.19), although there was no increase in the proportion of children with moderate or severe pain receiving analgesia. More children were weighed following the care bundle (OR 2.58 95% CI 1.86-3.57). Infants and children who were not weighed were more likely to receive an incorrect analgesia dose (p < 0.01). CONCLUSIONS: Rates of PS documentation improved and there was greater provision of analgesia overall following introduction of the care bundle. Although weighing of children did improve, the levels remain disappointingly low. EDs generally performed better than MIUs. The results show there were some improvements with this care bundle, but future work is needed to determine why pain management continues to fall below expected standards and how to further improve and sustain the impact of the care bundle.

dc.format.extent56-60
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherElsevier
dc.subjectPain assessment
dc.subjectPain management
dc.subjectPatient care bundles
dc.subjectEmergency service
dc.subjectNurse practitioners
dc.subjectBody weight
dc.subjectBefore and after study
dc.subjectEducation
dc.titleImplementation of paediatric pain care-bundle across South-West England clinical network of Emergency Departments and Minor Injury Units: A before and after study
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/30381143
plymouth.volume43
plymouth.publisher-urlhttp://dx.doi.org/10.1016/j.ienj.2018.10.001
plymouth.publication-statusPublished
plymouth.journalInternational Emergency Nursing
dc.identifier.doi10.1016/j.ienj.2018.10.001
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Users by role
dc.publisher.placeEngland
dcterms.dateAccepted2018-10-07
dc.rights.embargodate2019-10-29
dc.identifier.eissn1878-013X
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/j.ienj.2018.10.001
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-03
rioxxterms.typeJournal Article/Review


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