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Paediatric Pain Management for Painful Procedures in A&E – 2005 / 2006

Paediatric Pain Management for Painful Procedures in A&E – 2005 / 2006 . Linda Ewart Senior Nurse Practitioner. Facilitated by: The Clinical Audit & Effectiveness Department, JPUH. Objectives:.

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Paediatric Pain Management for Painful Procedures in A&E – 2005 / 2006

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  1. Paediatric Pain Management for Painful Procedures in A&E – 2005 / 2006 Linda Ewart Senior Nurse Practitioner Facilitated by: The Clinical Audit & Effectiveness Department, JPUH.

  2. Objectives: • To ensure effective pain management in children undergoing painful procedures in the A&E department and to reduce traumatisation.

  3. Rationale: • To meet children’s NSF standards (DoH 04). • To highlight areas for improvement regarding paediatric pain management. • To evaluate effectiveness of Hospital Play Specialist service in A&E.

  4. Type of procedure:

  5. Did child receive analgesia prior to procedure?

  6. Type of procedure & analgesia given (1):

  7. Type of procedure & analgesia given (2):

  8. Time between analgesia & procedure: • Total: • 16 hours, 15 minutes (975 minutes) • Range: • 5 minutes to 1 hour, 45 minutes • Average: • 39 minutes • (3 x n/a, 5 x unable to calculate)

  9. Duration of procedure: • Total: • 5 hours, 39 minutes (339 minutes) • Range: • 2 seconds to 1 hour, 40 minutes • Average: • 11.30 minutes • (2 x not answered, 1 x 20 seconds not included in the calculation)

  10. Pain score:

  11. Was the procedure painful or not?

  12. Was distraction therapy useful?

  13. Conclusions: • Positive • 8 categories of procedure (wound closure with steristrips/glue most common - 27%) • 85% children received analgesia • Positive feedback for Play Specialist input • 24 % did not have play specialist involvement

  14. Areas for improvement / Recommendations: • Need to formalise use of one Paediatric pain scale (scores 0-3) Trust-wide to avoid confusion & facilitate accurate evaluation of pain management. • For pain scores of 3, choose appropriate analgesia for severe pain, i.e. Morphine. • Once universal pain tool is decided, pain scores need to be documented on A&E paperwork. ? incorporate this on drug administration record sheet. • Re-audit in March'07 using one Paediatric pain assessment tool. • Adapt audit to capture pain score prior to analgesia & pain score after administration to assess analgesic effect. • Consider need to increase Play Specialist hours within A&E dept.

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