Epidemiology and neonatal pain management of heelsticks in intensive care units: EPIPPAIN 2, a prospective observational study |
| |
| Affiliation: | 1. Children''s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada;2. School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada;3. Children''s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada;4. Department of Maternal Child and Psychiatric Nursing, School of Nursing of the University of São Paulo, Rua Dr Enéas de Carvalho Aguiar, 419, Sao Paulo, SP 05403-000, Brazil;5. School of Nursing, Dalhousie University, 5869 University Avenue PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada;6. Better Outcomes Registry & Network (BORN) Ontario, Centre for Practice-Changing Research Building (CPCR), 401 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada;7. Department of Pediatrics, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada;8. School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada;9. Ottawa Hospital Research Institute, 501 Smyth Rd, Box 711, Ottawa, Ontario, K1H 8L6, Canada;10. The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada;11. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada;1. Trillium Health Partners, Mississauga, Ontario, Canada;2. The University of Toronto, Toronto, Ontario, Canada;3. The Hospital for Sick Children, Toronto, Ontario, Canada;4. IWK Health Centre, Halifax, Nova Scotia, Canada;5. Dalhousie University, Halifax, Nova Scotia, Canada;6. McGill University, Montréal, Québec, Canada |
| |
| Abstract: | BackgroundHeelstick is the most frequently performed skin-breaking procedure in the neonatal intensive care units (NICUs). There are no large multicenter studies describing the frequency and analgesic approaches used for heelsticks performed in NICUs.ObjectivesTo describe the frequency of heelsticks and their analgesic management in newborns in the NICU. To determine the factors associated with the lack of specific preprocedural analgesia for this procedure.DesignEPIPPAIN 2 (Epidemiology of Procedural PAin In Neonates) is a descriptive prospective epidemiologic study.SettingAll 16 NICUs in the Paris region in France.ParticipantsAll newborns in the NICU with a maximum corrected age of 44 weeks +6 days of gestation on admission who had at least one heelstick during the study period were eligible for the study. The study included 562 newborns.MethodsData on all heelsticks and their corresponding analgesic therapies were prospectively collected. The inclusion period lasted six weeks, from June 2, 2011 to July 12, 2011. Newborns were followed from their admission to the 14th day of their NICU stay or discharge, whichever occurred first.ResultsThe mean (SD) gestational age was 33.3 (4.4) weeks and duration of participation was 7.5 (4.4) days. The mean (SD; range) of heelsticks per neonate was 16.0 (14.4; 1–86) during the study period. Of the 8995 heelsticks studied, 2379 (26.4%) were performed with continuous analgesia, 5236 (58.2%) with specific preprocedural analgesia. Overall, 6764 (75.2%) heelsticks were performed with analgesia (continuous and/or specific). In a multivariate model, the increased lack of preprocedural analgesia was associated with female sex, term birth, high illness severity, tracheal or noninvasive ventilation, parental absence and use of continuous sedation/analgesia.ConclusionsHeelstick was very frequently performed in NICUs. Although, most heelsticks were performed with analgesia, this was not systematic. The high frequency of this procedure and the known adverse effects of repetitive pain in neonates should encourage the search of safe and effective strategies to reduce their number. |
| |
| Keywords: | Epidemiology Heel lance Heelstick Neonatal intensive care unit Neonate Nursing care Pain management Procedural pain |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
