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1. Premature babies undergo painful procedures without any pain medication 2. Children need better pain management procedures, study says 3. Pay-per-view: Poor communication cited in patient deaths at Boston hospital

Patient Safety Monitor Alert, November 12, 2003

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1. Premature babies undergo painful procedures without any pain medication

Hospitals must do a better job managing pain for premature babies, according to new research.

One recent study reveals that less than two-thirds of prematurely born, underweight babies (or neonates) received analgesic therapy to limit pain in an average of 14-daily procedures. About 40% didn't receive any analgesic therapy. Painful procedures included catheter insertion and suctioning fluids from the nose or throat.

Several researchers examined the amount and type of painful procedures performed on the 151 neonates studied during a 14-day visit to a neonatal intensive care unit (NICU) in Holland. Dick Tibboel, MD, PhD, of Erasmus MC-Sophia Children's Hospital in Rotterdam led the research.

Previous studies have shown that neonates are highly sensitive to pain, and that undergoing several painful procedures can lead to long-term, harmful consequences.

Tibboel's research appears in the November issue of The Archives of Pediatrics & Adolescent Medicine. Click here for more information or to access the study.

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2. Children need better pain management procedures, study says

Young children do not always receive the pain management they need, according to an article published in the November 12 issue of The Journal of the American Medical Association (JAMA).

The author, Richard F. Howard, MB, FRCA, of the the Great Ormond Street Hospital for Children NHS Trust in London, suggests that the following is needed:

* Education for parents about pain management so that they can actively help to manage their child's pain

* More research and new approaches

"Parents may underestimate and under treat pain, a particular concern because outpatient surgery is prevalent. Better communication with parents can improve subsequent pain management," Howard wrote in the article titled, "Current Status of Pain Management in Children."

Howard analyzed original research studies and reviews in medical literature from 1966 to 2003. He found a lack of comparable randomized controlled trials of children's pain management, and few published analyses or systematic reviews about the topic.

"Commonly used definitions of pain emphasize its personal sensory, emotional, and contextual nature, placing much reliance on an individual's ability to express what he or she feels when in pain," Howard said. "Children, particularly those who are preverbal or with limited cognitive capability, are clearly disadvantaged by this approach."

Click here for more information.

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3. Pay-per-view: Poor communication cited in patient deaths at Boston hospital

It's no accident that improving communication among caregivers made it on the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) National Patient Safety Goals.

Poor communication leads to thousands of medical errors each year, according to the Institute of Medicine. More recently, communication deficiencies were cited in three highly publicized deaths at Boston's Children's Hospital.

One case included a five-year-old boy who died after having an epileptic seizure while a resident and a physician on fellowship stood by at the child's bedside. Neither physician, nor several specialists who were consulted by phone, took definitive action, apparently because they weren't sure who was responsible for the boy's care.

Purchase this pay-per-view story today to learn techniques that your colleagues are using to avoid such tragic - and embarrassing - errors, including how one Hartford, CT, hospital is working to change how old-guard physicians communicate with nurses and each other. The cost is just $10.

Click here to purchase the story.

Note: If you are a "Briefings on Patient Safety" subscriber, you received the article as part of your November 2003 newsletter. If you're not a subscriber, subscribe today! Click here for a free sample.

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NEED TO CONTACT US?

Wendy Johnson, managing editor

wjohnson@hcpro.com

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