Nursing challenges in pain management in newborns in the neonatal intensive care unit
DOI:
https://doi.org/10.5281/zenodo.7372846Keywords:
“Newborn Pain”; “Nursing Knowledge in Neonatal Pain Assessment” and “Nursing in Neonatal Pain Management”.Abstract
Objective: to investigate the main challenges faced by nurses in pain management in newborns in the Neonatal Intensive Care Unit, as well as to identify nursing knowledge regarding pain management in newborns in the NICU. Method: this is an integrative literature review using the PRISMA flowchart. The search was conducted from 2017 to 2022, in the electronic databases Scientific Electronic Library Online (SCIELO), Medical Literature Analysis and Retrieval System Online (MedLine) and Database of Nursing (BDENF), and 22 articles were selected. For the guiding question, the PICO strategy was used. Results: to analyze the findings, three thematic axes were developed for content synthesis: "knowledge of professionals about neonatal pain assessment", "pharmacological and non-pharmacological measures for neonatal pain management" and "main challenges faced by nurses in neonatal pain management". Conclusion: the main challenges faced by nursing, especially the difficulty in implementing technical-scientific knowledge in daily practice and the undertreatment of pain in newborns, corroborate the inadequate management of neonatal pain. Therefore, it is essential to implement strategies for training, aiming at the improvement of clinical practice.
Keywords: “Newborn Pain”; “Nursing Knowledge in Neonatal Pain Assessment” and “Nursing in Neonatal Pain Management”.
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Brasil. Ministério da Saúde. Portaria n.º 930, de 10 de maio de 2012. Define as diretrizes e objetivos para a organização da atenção integral e humanizada ao recém-nascido grave ou potencialmente grave e os critérios de classificação e habilitação de leitos de Unidade Neonatal no âmbito do Sistema Único de Saúde (SUS). Diário oficial da União 2012, 10 mai. 2012. Seção 1. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/prt0930_10_05_2012.html
Ferraresi MF, Arrais AR. Evaluation of the Multidisciplinary Assistance provided in a Public Neonatal Care Unit from mother 's perception. Rev. Bras. Saude Mater. Infant. 2018; 18(2):391-400. Disponível em: https://doi.org/10.1590/1806-93042018000200008
Pontes KAES, Oliveira SS, Gomes L, Rotenberg L. O olhar da equipe de enfermagem sobre o trabalho em uma unidade neonatal: uma intervenção com foco na atividade. Rev Bras Saude Ocup. 2020; 45:e12. Disponível em: https://doi.org/10.1590/2317-6369000013218
Romantsik O, Calevo MG, Norman E, Bruschettini M. Clonidine for pain in non‐ventilated infants. Cochrane Database Syst Rev. 2020; 2020(4): CD013104. Disponível em: https://doi.org/10.1002%2F14651858.CD013104.pub2
Olsson E, Ahl H, Bengtsson K, Vejayaram DN, Norman E, Bruschettini M, Ericksson M. The use and reporting of neonatal pain scales: a systematic review of randomized trials. Pain. 2021; 162(2):353-360. Disponível em: https://doi.org/10.1097/j.pain.0000000000002046
Popowicz H, Kwiecień-Jaguś K, Olszewska J, Mędrzycka-Dąbrowska WA. Pain Scales in Neonates Receiving Mechanical Ventilation in Neonatal Intensive Care Units – Systematic Review. J Pain Res. 2020; 13:1883-1897. Disponível em: https://doi.org/10.2147/jpr.s248042
Campos APS. Neonatal pain: knowledge, attitude and practice of the nursing team. Br J Pain. 2018; 1(4):354-8. Disponível em: https://doi.org/10.5935/2595-0118.20180067
Donato H, Donato M. Stages for Undertaking a Systematic Review. Acta Med Port. 2019; 32(3):227-235. Disponível em: https://doi.org/10.20344/amp.11923
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et. al. PRISMA Extension For Scoping Reviews (PRISMA-5cR): Checklist and Explanation. Ann Intertn Med. 2018; 169(7):467-473. Disponível em: https://doi.org/10.7326/M18-0850
Merces MC, Gomes AMT, Coelho JMF, Servo MLS, Marques SC, Júnior AO. Evidências científicas sobre a associação entre burnout e síndrome metabólica: revisão integrativa. Acta Paul Enferm. 2019; 32(4):470-6. Disponível em: https://doi.org/10.1590/1982-0194201900064
Bonutti DP, Daré MF, Castral TC, Leite AM, Vici-Maia JA, Scochi CGS. Dimensioning of painful procedures and interventions for acute pain relief in premature infants. Rev. Latino-Am. Enfermagem. 2017; 25:e2917. Disponível em: https://doi.org/10.1590/1518-8345.1387.2917
Sposito NPB, Rossato LM, Bueno M, Kimura AF, Costa T, Guedes DMB. Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study. Rev. Latino-Am. Enfermagem 2017; 25:e2931. Disponível em: https://doi.org/10.1590/1518-8345.1665.2931
Querido DL, Christoffel MM, Machado MED, Almeida VS, Esteves APVS, Matos PBC. Perceptions of professionals on neonatal pain: a descriptive study. Online Braz J Nurs. 2018; 16(4):420–430. Disponível em: https://doi.org/10.17665/1676-4285.20175847
Silva SF, Rolim KMC, Albuquerque FHS, Santos MSN, Pinheiro MCD, Frota MA. Intervenções não farmacológicas no controle da dor em recém-nascidos pré-termo: conhecimento da equipe de enfermagem. Revista Nursing. 2021; 24(278):5892-5896. Disponível em: https://doi.org/10.36489/nursing.2021v24i278p5892-5901
Silva GA, Ichisato SMT, Vieira BAJ, Nunes MSA, Rossa R, Bergantini LS. Estudo de Caso Intrínseco de um Recém-Nascido Prematuro: Procedimentos Dolorosos. Rev Enferm Atual In Derme. 2022; 96(38):e-021260. Disponível em: https://doi.org/10.31011/reaid-2022-v.96-n.38-art.1384
Moraes ELL, Freire MHS. Painful and stressful procedures and analgesia in newborns from the viewpoint of professionals. Rev Bras Enferm. 2019; 72(3):170-7. Disponível em: https://doi.org/10.1590/0034-7167-2018-0326
Barros MMA, Luiz BVS, Mathias CV. Pain as the fifth vital sign: nurse's practices and challenges in a neonatal intensive unit care. BrJP. 2019; 2(3):232-6. Disponível em: https://doi.org/10.5935/2595-0118.20190041
Carvalho SS, Soares JA, Pinheiro JA, Queiroz MS. Percepção da Equipe de Enfermagem Acerca da Avaliação da Dor em Recém-Nascidos Prematuros. Rev Enferm Atenção Saúde. 2021; 10(2):e202117. Disponível em: https://doi.org/10.18554/reas.v10i2.4281
Christoffel MM, Castral TC, Daré MF, Montanholi LL, Gomes ALM, Scochi CGS. Atitudes dos profissionais de saúde na avaliação e tratamento da dor neonatal. Esc Anna Nery. 2017; 21(1):e20170018. Disponível em: https://www.scielo.br/j/ean/a/JFQ4N4gDZNN44q3kFD8dfjv/?format=pdf&lang=pt
Misic MC, Andersen RD, Strand S, Eriksson M, Olsson E. Nurses' perception, knowledge, and use of neonatal pain assessment. Paediatr Neonatal Pain. 2021; 3(2):59–65. Disponível em: https://doi.org/10.1002%2Fpne2.12050
Marques ACG, Lamy ZC, Garcia JBS, Gonçalves LLM, Bosaipo DS, Silva HDC, et al. Avaliação da percepção de dor em recém-nascidos por profissionais de saúde de unidade neonatal. Cad. Saúde Colet. 2019; 27(4):432-436 Disponível em: https://doi.org/10.1590/1414-462X201900040156
Rocha VA, Silva IA, Cruz-Machado SS, Bueno M. Painful procedures and pain management in newborns admitted to an intensive care unit. Rev Esc Enferm USP. 2021; 55:e20210232. Disponível em: https://doi.org/10.1590/1980-220X-REEUSP-2021-0232
Costa T, Rossato LM, Bueno M, Secco IL, Sposito NPB, Harrison D, et al. Nurses' knowledge and practices regarding pain management in newborns. Rev Esc Enferm USP. 2017; 51:e03210. Disponível em: https://doi.org/10.1590/S1980-220X2016034403210
Wari G, Wordofa B, Alemu W, Habte T. Knowledge and Practice of Nurses and Associated Factors in Managing Neonatal Pain at Selected Public Hospitals in Addis Ababa, Ethiopia, 2020. J Multidiscip Healthc. 2021; 14:2275–2286. Disponível em: https://doi.org/10.2147%2FJMDH.S322903
Araújo BS, Araújo BBM, Araújo MC, Pacheco STA, Reis AT, Marta CB. Assessment and management of pain in the neonatal unit. R. pesq.: cuid. fundam. Online. 2021; 13:531-537. Disponível em: http://dx.doi.org/10.9789/2175-5361.rpcfo.v13.9287
Popowicz H, Mędrzycka-Dąbrowska W, Kwiecień-Jaguś K, Kamedulska A. Knowledge and Practices in Neonatal Pain Management of Nurses Employed in Hospitals with Different Levels of Referral—Multicenter Study. Healthcare. 2021; 9(1):48. Disponível em: https://doi.org/10.3390%2Fhealthcare9010048
Maciel HIA, Costa MF, Costa ACL, Marcatto JO, Manzo BF, Bueno M. Pharmacological and nonpharmacological measures of pain management and treatment among neonates. Rev Bras Ter Intensiva. 2019; 31(1):21-26. Disponível em: https://doi.org/10.5935/0103-507X.20190007
Moura DM, Souza TPB. Knowledge of the neonatal intensive care unit nursing team about newborn pain. BrJP. 2021; 4(3):204-9. Disponível em: https://www.scielo.br/j/brjp/a/D6vBFMjnF9mFd35LPVznDHz/?format=pdf&lang=pt
Soares MFE, Chaves AVG, Morais APS, Rabelo MZS, Rodrigues LN, Chaves EMC. Newborn's pain under the mother's perception. Rev Dor. 2017; 18(4):338-41. Disponível em: https://www.scielo.br/j/rdor/a/X7D6tyPMjQfdCBbXyYQpQ7p/?format=pdf&lang=pt
Treiman-Kiveste A, Pölkki T, Kalda R, Kangasniemi M. Nurses' perceptions of infants’ procedural pain assessment and alleviation with non-pharmacological methods in Estonia. Journal of Pediatric Nursing. 2022; 62:e156–e163. Disponível em: https://doi.org/10.1016/j.pedn.2021.09.006
Almeida HCC, Candido LK, Harrison D, Bueno M. Seja Doce com os Bebês: avaliação de vídeo instrucional sobre manejo da dor neonatal por enfermeiros. Rev Esc Enferm USP. 2018; 52:e03313. Disponível em: http://dx.doi.org/10.1590/S1980-220X2017033903313
Christoffel MM, Querido DL, Silveira ALD, Magesti BN, Gomes ALM, Silva ACCS. Health professional’s barriers in the management, evaluation and treatment of neonatal pain. BrJP. 2019; 2(1):34-8. Disponível em: https://doi.org/10.5935/2595-0118.20190007