Assessment of pain in children with brain injury: Moving to best practice

摘要

Nurses are guided to use pain tools for assessing pain. Appropriate tools exist for all ages of children, as well as accounting for diverse communicative abilities and impairments such as brain injury. Use of pain tools, and good documentation of pain management, is part of providing best practice, high-quality care. Clinical audit, based on compliance with the Royal College of Nursing guideline for pain assessment, measured current and changing practice at a 70-bed national specialist centre for children with brain injury. Compliance was initially poor. Changes in practice were supported by evidence-based measures, including a written guideline, classroom teaching, visits to practice areas, sharing of audit results, reminders and a special interest group. Over 3 years, the audits showed an increase of child-specific pain tools available in children's care files from 9% to 83%; assessment of pain using a pain tool, when indicated, increased from 0 to 30%. Documentation of interventions to relieve pain increased from 51% to 80% and reassessment of pain following an intervention increased from 15% to 63%. This article will resonate with any organisation trying to embed systematic pain assessment into routine practice.