Changing healthcare provider and parent behaviors in the pediatric post‐anesthesia‐care‐unit to reduce child pain: Nurse and parent training in postoperative stress

This research report presents the development and evaluation, as well as the results of the implementation, of a behavioural intervention (Nurse and Parent Training in Postoperative Stress [NP‐TIPS]) to change the behaviours of nurses and parents in the PACU, with the intention to alter behaviours that may impact on the child’s pain. For example, promoting behaviours that may decrease pain including distraction and coping advice, while reducing behaviours that may increase pain including apology, empathy and reassurance. 23 nurses participated in pre-intervention data collection then went through the training and were used for the post-intervention data collection. Pre and post parent-child dyads had 52 and 60 recruitments, respectively.

Results: nurses increased the desired behaviours by over 200% while decreasing non‐desired behaviours by 62%. Similarly, parents increased desired behaviours by over 100% and decreased non‐desired behaviours by 26%. The children in the intervention group had significantly less pain in PACU (P=0.001), especially at the beginning of their PACU stay (P<0.001).

Limitations: no blinding was able to be done of the participants (parents and nurses) and researchers. Also, the expected pain for each operation, as well as analgesia given intra-operatively, was not analysed for pre- and post-intervention.

Take Home Message:

Making small changes to the way we use language around pain is easy to do and may make a difference to how post-operative pain is experienced in children.

Reviewed by: Dr Vanessa Rich