Most Proposed Topic :
HA Young Investigators Session (projects to be presented by and HA staff who had joined HA for less than 15 years)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors: (including presenting author): :
YEUNG ST(1), CHAN WC(1), KWAN KL(1), SO TW(1), WONG FH(1), WONG KY(1), CHIU GS(1)
Affiliation: :
(1) Neonatal Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital
Introduction: :
Newborn babies in NICU were exposed to multiple painful procedure during hospitalization. Frequent pain exposure can cause negative impacts on their growth, cognitive, motor, and neurodevelopment. Therefore, neonatal pain should be regularly assessed and managed timely. The present pain assessment tool in our ward is one-dimensional and mainly used for measuring postoperative pain but not chronic pain. Therefore, we introduce the COMFORTneo scale as a new comprehensive and evidence-based pain scale in NICU to enhance pain assessment in NICU.
Objectives: :
(1) Reinforce the importance of regular pain assessment for neonates;
(2) Enhance the knowledge of nurses on the COMFORTneo scale;
(3) Enhance nurses’ clinical competencies in performing pain assessments of neonates by using the COMFORTneo scale.
Methodology: :
A pain management workgroup with all stakeholders was formed in August 2023. One group pretest-posttest design was used. Online pre-test questionnaires were conducted to assess nurses’ baseline awareness and knowledge of neonatal pain. Small group education talk was delivered by workgroup members to all NICU nurses. After the education talk, post-test questionnaires with the same questions were conducted and nurses were required to view the selected video clips to perform pain assessment of 3 neonates by using the COMFORTneo scale. 30 NICU nurses were recruited by convenience sampling method to participate in a trial implementation of the COMFORTneo scale by performing pain assessment on patients simultaneously but independently with the workgroup members.
Result & Outcome: :
In pre-test, most participants stated that pain assessment should be done when babies are under analgesic and after immediate post-operation. After education talk, there was an increase of 74.2% and 53.1% of participants stating that pain assessment would also be performed when babies are under non-invasive or invasive mechanical ventilation respectively. Moreover, there was an increase of 82.5% of participants changed their thoughts that pain assessment should be performed once per shift. All participants in post-test agreed that pain assessment is important for the development of babies, 100% of them could spot all the 7 behavioral items included in the COMFORTneo scale and standard time range needed for observation. The difference between the COMFORTneo score obtained by workgroup members and participants in post-test and trial implementation had no statistical significance (p>0.05), which indicated that participants could use the COMFORTneo scale appropriately and competently. In conclusion, the introduction and education program of the COMFORTneo scale successfully raised NICU nurses’ awareness of neonatal pain and the nurses’ clinical competencies in using the COMFORTneo scale.
