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Improved Care and Prevention Improving pain management in newborns

Denise Harrison, Children’s Hospital of Eastern Ontario
Denise Harrison, Children’s Hospital of Eastern Ontario

A cluster randomized controlled trial in Ontario hospitals providing maternal/newborn care to determine effectiveness of a parent-targeted educational video for improving newborn pain treatment (The ONesiE study – Caring for Babies: A Study of Ontario Newborn-maternal Hospitals on the Effectiveness of Parent-targeted Education)

Issue

  • Preterm and sick babies require many painful blood tests and procedures during hospitalization. Repeated painful procedures put preterm and sick babies at increased risk of long-term developmental delays.
  • The good news is that research has shown there are simple, effective, and free (or inexpensive) ways to reduce pain in newborn babies. Breastfeeding, holding babies skin-to-skin before and during blood tests or giving babies just a few drops of sugar water (sucrose), effectively reduce pain as shown by less crying and less struggling.
  • However, babies in many settings continue to suffer unnecessarily during painful procedures despite evidence and Canadian and international guidelines recommending pain reduction techniques.
  • To date, education aimed at improving pain care for babies has primarily targeted health care providers.

Project

  • To address this problem, the research team partnered with parents of babies and young children, health care providers (including nurses, midwives and physicians), researchers in Canada, and key organizations such as BORN Ontario, and the Baby Friendly Hospital Initiative (BFHI), to produce a short video showing how parents can help their babies during blood tests.
  • This research project will evaluate whether the video, if made easily available and promoted in maternal/newborn units that care for mothers and babies in Ontario, increases use of recommended pain treatment strategies during newborn screening.
  • The calming effects of these strategies are powerfully portrayed and the voice-over explains how parents can help their babies by partnering with nurses and doctors to use these strategies.
  • The video was posted onto YouTube in 2014, for wide-spread knowledge dissemination. However, YouTube is a passive means of disseminating knowledge and the impact on clinically important outcomes is unknown.

Patient engagement

  • The project team has engaged a parent of three children in the design of this randomized controlled trial and in the pilot studies informing this project.
  • The parent helped to identify research priorities, shared stories from other parents whose newborns experienced painful procedures, and was involved in the production, evaluation and revisions of the BSweet2Babies video. The parent will also advise on knowledge translation and policy recommendations.
  • Two other parents, recent immigrants, were engaged to bring their perspectives as first-time parents and will advise on the implementation of the intervention. They will bring ensure that cultural factors are considered in the results and dissemination of the research findings.

Publications