scholarly journals Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

2021 ◽  
Vol 9 ◽  
Author(s):  
Eleni Agakidou ◽  
Konstantia Tsoni ◽  
Theodora Stathopoulou ◽  
Agathi Thomaidou ◽  
Maria Farini ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Assessment Tools ◽  
Procedural Pain ◽  
Time Points ◽  
Neonatal Pain ◽  
The Past ◽  
Long Term Consequences ◽  
Experience Pain

Intense research for more than three decades expelled the view that neonates do not experience pain. The aim of this survey was to investigate whether the Greek physicians involved in neonatal intensive care have changed their perceptions regarding neonatal pain, adapting their management practices to the knowledge that have emerged in the past 20-years. This study is a survey conducted at two time-points, 20 years apart. Anonymous questionnaires were distributed to 117 and 145 physicians working in neonatal intensive care units (NICUs) all over Greece in years 2000 and 2019, respectively. The response rate was 90.6 and 80.7% in 2000 and 2019, respectively. All respondents, at both time-points, believed that neonates experience pain, which has serious acute and long-term consequences, while the vast majority considered analgesia-sedation (A-S) during painful interventions as obligatory. Utilization of NICU protocols and pain assessment tools remained low although increased significantly between 2000 and 2019. The use of systemic A-S postoperatively was high at both time-points, while its implementation in infants subjected to prolonged pain, specifically mechanical ventilation, increased significantly by 2019. Systemic or local analgesia for acute procedural pain was used by lower proportions of physicians in 2019, except for the tracheal intubation. In contrast, the use of sweet solutions and non-pharmacological measures prior to or during bedside procedures significantly increased over time. Opioid administration significantly increased, while a shift from morphine to fentanyl was observed. International literature and perinatal–neonatal congresses were stated as the main sources of updating physicians' knowledge and improving management practice on neonatal pain prevention and treatment. In conclusion, Greek NICU-physicians' perceptions that neonates can experience pain with potentially serious acute and long-term consequences remained strong over the past 20 years. Although physicians' practices on neonatal pain management improved, they are still suboptimal, while significant differences exist among centers. Continuing education, globally accepted management protocols, and readily applied pain assessment tools would further improve the management of procedural pain and stress in neonates.

scholarly journals Singing, sharing, soothing – biopsychosocial rationales for parental infant-directed singing in neonatal pain management

2018 ◽  
Vol 1 ◽  
pp. 205920431878084 ◽  
Author(s):  
Alexandra Ullsten ◽  
Mats Eriksson ◽  
Maria Klässbo ◽  
Ulrik Volgsten
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Neonatal Intensive Care ◽  
Parental Participation ◽  
Music Therapist ◽  
Neonatal Pain ◽  
Short And Long Term ◽  
Early Parent ◽  
Pain Care

Infant-directed singing is a medium for parents and infants to communicate in a mutual relationship. Parental infant-directed singing is a multisensory, biopsychosocial communication that applies to ill and vulnerable hospitalised infants. The primary musical features of infant-directed singing are ideal for emotional coordination and sharing between parent and infant without the risk of over-stimulation. In this article, we suggest that parental infant-directed singing is regarded as a nonpharmacological emotion regulation intervention, which may modify the painful experience for both the infant and the parent before, during and after painful procedures in the neonatal intensive care context. Parents have the biopsychosocial resources to alleviate their infant’s pain through infant-directed singing, if they are empowered to do so and coached in this process. A music therapist specialised in neonatal music therapy methods can mentor parents in how to use entrained and attuned live lullaby singing in connection to painful procedures. Pain and the vast amount of painful procedures early in infancy, combined with early parent–infant separation and lack of parental participation in the care of the infant during neonatal intensive care, place arduous strain on the new family’s attachment process and on the infant’s and parents’ mental health, both from a short and long-term perspective. Therefore, we argue with biopsychosocial rationales, that live parental infant-directed singing should be promoted in neonatal pain care worldwide. Consequently, parents should be welcomed round the clock and invited as prescribed pain management for their infant.

Early Intubation and MAS

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 269-269
Author(s):  
THOMAS E. WISWELL
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Upper Airway ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
The Past ◽  
Early Intubation

In Reply.— I appreciate the comments of Dr Traverse. His opinions and practices closely reflect my own. I, too, am unaware of proven long-term sequelae which can be attributed directly to intubating meconium-stained infants once or twice.1 Additionally, I attempt to remove meconium from the upper airway in all meconium-stained infants, be they vigorous or healthy, or the meconium thick or thin. During the past 5 years, fully one third of infants with the meconium aspiration syndrome (MAS) admitted to our Neonatal Intensive Care Unit had not been intubated and had their tracheae suctioned.

Methadone effectively attenuates acute and long-term consequences of neonatal repetitive procedural pain in a rat model

2021 ◽  
Author(s):  
Nynke J. van den Hoogen ◽  
Thomas J. de Geus ◽  
Jacob Patijn ◽  
Dick Tibboel ◽  
Elbert A. Joosten
Keyword(s):  
Rat Model ◽  
Procedural Pain ◽  
Long Term Consequences

scholarly journals Knowledge and Practices in Neonatal Pain Management of Nurses Employed in Hospitals with Different Levels of Referral—Multicenter Study

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 48
Author(s):  
Hanna Popowicz ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Katarzyna Kwiecień-Jaguś ◽  
Agnieszka Kamedulska
Keyword(s):  
International Organizations ◽  
Neonatal Intensive Care ◽  
Medical Personnel ◽  
Assessment Tools ◽  
Neonatal Intensive Care Units ◽  
Neonatal Pain ◽  
Level Of Knowledge ◽  
Nurses Perceptions ◽  
Quantitative Descriptive ◽  
Different Levels

Background: One of the key elements of patient care is the relief and prevention of pain sensations. The importance of pain prevention and treatment has been emphasized by many international organizations. Despite the recommendations and guidelines based on evidence, contemporary research shows that the problem of pain among patients in neonatal intensive care units (NICUs) in various centers is still an important and neglected problem. Aim: The aim of this study was to assess the level of knowledge of the medical personnel and their perception of the issue of pain in neonatal patients. Methods: A quantitative descriptive study carried out in 2019. The study used a nurses’ perceptions of neonatal pain questionnaire. Results: A total of 43 Polish hospitals and 558 respondents participated in the project. 60.9% (n = 340) and 39.1% (n = 218) of respondents were employed in secondary and tertiary referral departments, respectively. Conclusion: Our analyses indicate that despite the availability of pain assessment tools for neonatal patients, only a few centers use standardized tools. The introduction of strategies to promote and extend the personnel’s awareness of neonatal pain monitoring scales is necessary.

Individualized Developmental Care in the Neonatal Intensive Care Nursery

2008 ◽  
Vol 17 (3) ◽  
pp. 84-93
Author(s):  
Kathleen A. VandenBerg ◽  
Erin Sundseth Ross
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Advanced Practice ◽  
Developmental Care ◽  
Medical Interventions ◽  
Speech Language Pathologist ◽  
Developmentally Supportive Care ◽  
Intensive Care Nursery ◽  
Infant Brain Development

Abstract Advances in medical care have improved the success of medical interventions in treating high-risk and premature infants, but long-term developmental outcomes are less positive. The neonatal intensive care unit (NICU) setting influences infant brain development and organization, as well as the parent-infant relationship. One advanced-practice role for a speech-language pathologist (SLP) is that of a newborn developmental specialist (NDS). The NDS working in the NICU understands the influence of medical, environmental, and caregiving interactions on the neurologic and neurobehavioral organization of the infant. The NICU setting advanced practice skills are grounded in an individualized, developmentally supportive care model, such as the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Neurodevelopmental assessment focuses on the competence of the infant. The developmental assessment and intervention strategies are individualized to support the infant's own goal strivings. In this framework, interactions with infants become modified to increase competence and organization. The SLP working in the NICU is in a unique position to facilitate communication between the infant and the parent, as well as between the infant and professional caregivers. The SLP can help the parent interpret and respond appropriately to the infant's communication by focusing on non-verbal stress and stability cues, and by planning all interactions with a goal of co-regulation. Interactions with infants and families in this Model in the NICU have beneficial lifelong implications.

scholarly journals Please Don’t Use the Restraints

2015 ◽  
Vol 22 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Desireé D. Rowe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Birth Experience ◽  
The Past ◽  
The Future ◽  
Life Threatening ◽  
New Perspective

The end of the story is all you care about. So, let’s get that out of the way first. Penelope Jane was born on March 23rd. She was healthy. The trauma of that day still resonates within my body, called into being through subsequent visits to the hospital and a review of my own medical records from that day. A life-threatening fever and 9 hours of pushing led to a powerfully negative birth experience, one that I am consistently told to just forget. After she had a weeklong stay in the neonatal intensive care unit (NICU), I have a healthy daughter. In this article, I use auto/archeology as a tool to examine my own medical records and the affective traces of my experience in the hospital to call into question Halberstam’s advocacy of forgetting as queer resistance to dominant cultural logics. While Halberstam explains that “forgetting allows for a release from the weight of the past and the menace of the future” I hold tightly to my memories of that day. This article marks the disconnects between an advocacy of forgetting and my own failure of childbirth and offers a new perspective that embraces the queer potentiality of remembering trauma.

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