Pediatric pain and why it needs to matter to you: Reigniting the common good in nursing care excellence

Background: Pain matters. Pain is ranked in the top three concerning symptoms that find pediatric patients in an emergency department every year. When a patient and family survey as well as provincial data reports all listed pain as such a high-ranking concern, it was important to act. A review of all site resources demonstrated that we were void of any policies, guidelines, clinical expectations or practice documents that addressed pediatric pain: how to assess it and how to manage it. Literature is very clear that unmanaged pediatric pain is catastrophic for neurologic and psychosocial development, comorbidities, prolonged healing, increased hospital admission and frequency of emergency visits. Pain impacts the patient, the family, the social network, the staff and the system. Objectives: Through this presentation, participants will: 1. Review the catastrophic impact of untreated and undertreated pediatric pain 2. Analyze local and provincial research data that illustrates the current gap that exists in pediatric pain care 3. Examine a strategy used to impact sitewide culture change regarding pediatric pain care, assessment and management, in a sustainable way 4. Identify applications of knowledge in clinical practice with accessible ways of breaking the pain pathway in any setting that treats pediatric patients 5. Recognize the gap as it exists presently in the clinical setting and identify key strategic ways to instigate lasting change Methods: Utilizing the principles of pediatric pain care of an international organization as the gateway to bring about change, the pediatric pain campaign was launched site wide with an overwhelming impact. The foundational layer of the work was outlined by the international designation that the site set out to achieve. The reach and strength of the culture shift could not have been anticipated to be such a powerful and impactful force. Results: • Teams that engaged the work spanned from all clinical areas initially and then began to encompass non-clinical staff: environmental services, lab services, and patient food services • A site wide dashboard was created to capture any pain data from through the use of EPIC and can be as specific as a unit or program or as vast as the entire site • Site wide pain policies and clinical supporting documents were written and posted in every patient room through emergency, ambulatory and inpatient • Pain was linked to the site strategic priorities ensuring that it remains a priority for all departments and staff to continue to work on pain care in the pediatric population Implications and lessons learned: Untreated or undertreated pain is a significant concern in the pediatric population and will end up costing the patient, the family, and the system if it is not addressed. Working toward an international designation that marks a site commitment to pain care from neonate to adolescence is an imperative foundation to accomplish the work required to bring an entire hospital onboard. Holistic pain care from assessment to management to prevention is a basic commitment that is an achievable goal within the healthcare system. Let’s reignite our passion as we strive for excellence in pediatric pain care.