Abstract
Problem: Pain management in the NICU has remained a challenge despite advances in the field of neonatology. Repeated exposure to painful procedures in the NICU without adequate pain management is thought to be the cause of neurobehavioral issues that arise in premature infants later in life. These neurobehavioral issues are expensive to manage and can ideally be avoided with effective pain management during painful procedures.|Methods: The nursing staff in a local NICU in Omaha, NE and Charleston, SC were surveyed to determine their perception of whether they were providing effective pain management techniques during painful procedures such as heel sticks, intubation and central line placement and to determine variations in pain management. The Pain Management questionnaire was adapted from Akuma and Jordan's Pain Management questionnaire. Sample included 106 respondents with 51 neonatal nurse practitioners and 55 nurses.|Results: The nurses and NNPs who were surveyed understand the theories of pain in the neonate. Respondents perceived that heel sticks were the least painful procedure and that chest tube insertion was the most painful procedure. Both comfort care and analgesia are used with the most painful procedures. Overall, respondents felt that there were no concerns about over-medicating the infants, but there was a concern about under medicating infants during procedures. The nurses had a higher concern about under medication than the NNPs.|Conclusions: Since most nurses have a good knowledge base on neonatal pain, no further education in the area is required. The nurses do feel that there is still under medication of neonates during procedures. The NNPs have less of a concern about under medication, and this could be due to their ability to order more medication if the infant requires it. More effective communication between the nurses and the NNPs/physicians is needed to make sure that all infants are medicated as needed for pain in the NICU.