Implementation of The Comfort Promise to Reduce Pediatric Procedural Pain: A Quality Improvement Project
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Authors
Feltner, Brittany
Issue Date
2024-08
Type
Presentation
Language
Keywords
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Abstract
Abstract
Purpose: The purpose of this quality improvement project was to implement the Comfort Promise for needle procedures and evaluate the implementation process and nurses' perception of its use.
Background: Ineffective proactive pediatric pain control leads to needle phobia, anticipatory fear, and avoidance of future medical care. Both the American Academy of Pediatrics and the American Pain Society released position statements urging providers to address gaps in acute pediatric pain. The Comfort Promise is an agreement between the caregivers and the patient that considers strategies such as age-appropriate distraction, positions of comfort, topical numbing, and oral sucrose or breast feeding for infants to decrease children’s pain with needle procedures.
Sample/Setting: Nurses working on a 14 bed midwestern pediatric unit caring for patients ages 0-18 admitted to the pediatric hospitalist service requiring needle procedures for lab draws, intravenous access, intramuscular or subcutaneous medication, or immunizations.
Methods: The nurses’ responses pre/post implementation of the Comfort Process evaluated their pediatric pain management. Chart audits determined integration of the patient’s comfort measure preference and utilization of those specific strategies during needle procedures.
Results: Nurses’ post intervention responses demonstrated an increase in comfort measure use from 10% to 41%. Physical restraint use during needle procedures decreased from 26% to 8%. Chart audits suggested that 50% of FYI patient preferences matched the measures utilized during the needle procedure.
Conclusion: The integration of the Comfort Promise indicated the potential for enhancing nursing knowledge of pediatric pain management and promoted collaboration between patients and nurses to optimize the pain experience during needle pokes.
Keywords: pediatric, procedural pain, needle pain, pain control, childhood pain, painful procedures, Buzzy, topical anesthetic, distraction, comfort promise, intravenous access.