Preliminary Construction Of Pain Management Training Program For Nurses In Neonatal Intensive Care Unit

ObjectiveTo understand the current situation of nurses’ knowledge,attitudes and clinical practice of neonatal pain management in neonatal intensive care unit,and analyze their clinical training needs.On this basis,combined with literature review,to construct a scientific and standardized training program for neonatal intensive care unit nurses’ pain management,providing reference for medical institutions to implement neonatal pain management training.Methods1.Questionnaire survey method: Using a multi-stage sampling method,a general information questionnaire,a survey questionnaire on pain knowledge and attitude among newborn pediatric nurses,and a survey questionnaire on pain assessment and management among newborn pediatric nurses(Chinese version)were used as research tools.From December 2021 to February 2022,a survey was conducted in Dalian City,Liaoning Province,including 1 tertiary A hospital,1 tertiary comprehensive hospital,and 1 tertiary specialized hospital for women and children 101 nurses from a second level specialized hospital for women and children in the neonatal intensive care unit were recruited to understand their knowledge,attitude,and clinical practice of neonatal pain management.Their clinical training needs were analyzed,and a literature review was conducted to preliminarily construct various indicators for the pain management training program for nurses in the neonatal intensive care unit.2.Delphi expert consultation method: select experts in the fields of pediatric nursing management,nursing education,newborn medical care,nursing and anesthesia as the consultation object,conduct two rounds of expert consultation on the initially constructed training plan,use SPSS25.0 to statistically analyze the positive coefficient,authority coefficient,concentration and coordination degree of the consultation experts,and combine the experts’ opinions to screen the contents of indicators at all levels of the training plan Revise and improve the final pain management training program for nurses in neonatal intensive care unit.Results1.A total of 101 survey questionnaires were collected for the current situation survey,of which 99 were valid,with an effective rate of 98.01%.The average score of the questionnaire on pain knowledge and attitude among nurses in the neonatal intensive care unit is(68.22 ± 11.76).Among them,the three items with the lowest accuracy are obstacles in pain management(accuracy rate of 20.79%),adverse reactions of various analgesics(accuracy rate of 24.26%),and non pharmacological analgesics for newborns(accuracy rate of 39.60%).The survey on pain assessment and management among nurses in the neonatal intensive care unit showed that only 38.4% of nurses believe they have the ability to explain the scores measured by pain assessment tools.39.4% of nurses believe that their workplace regularly uses neonatal pain assessment tools.50.5% of nurses reported that neonatal pain was well managed in their workplace.65.7% and 66.7% of nurses respectively believe that they have confidence in the use of medication interventions for neonatal pain and non medication interventions.93.94% of nurses hope to continue participating in learning about neonatal pain related knowledge.2.This study conducted two rounds of Delphi expert consultation,selecting 20 experts,of which 17 participated in the two rounds of consultation.The 17 experts come from 6 hospitals in 5 regions including Henan Province,Anhui Province,Jiangsu Province,Liaoning Province,and Shenzhen City,including tertiary A children’s specialized hospitals and women’s and children’s comprehensive hospitals.The average age of consulting experts is(44.71 ± 5.16)years old.14 deputy senior professional titles and 3 senior professional titles.The average working experience is(23.65 ± 6.23)years.Among them,there are 7 pediatric nursing education and nursing management experts,8 neonatal nursing experts,and 2 neonatal medical and anesthesia experts.Experts are widely distributed and cover a wide range of specialties,with rich clinical work,management experience,and research capabilities in pediatrics.3.The expert consultation results show that the positivity coefficients of the two rounds of consultation experts are 85% and 100%,respectively,indicating that the experts have high enthusiasm for this study.The authority coefficients of the two rounds of consultation experts are 0.89 and 0.92,respectively,indicating a good level of expert authority.The average value range of importance assignment for various indicators in the first round of expert consultation is 4.29-5.00,and the full score range is 41.18%-100%;The average value range for the importance assignment of indicators at all levels in the second round of expert consultation is 4.24 to 5.00,and the full score range is 29.41% to 100%.The coefficient of variation of indicators at all levels in two rounds of expert consultation ranges from 0.00 to 0.16;The overall Kendall coordination coefficients of the two rounds of expert consultation were 0.203 and 0.309,respectively,with both P<0.001.The difference was statistically significant,and the expert opinions tended to be consistent.The final training plan for pain management for nurses in the neonatal intensive care unit includes 4 primary indicators,15 secondary indicators,and 60 tertiary indicators.Conclusions1.Nurses in neonatal intensive care unit have insufficient knowledge of neonatal pain management.In order to better care for this special group,prevent and reduce the occurrence of neonatal pain stimulation,it is urgent to carry out standardized and systematic neonatal pain management training.2.This study is a pain management training program for nurses in neonatal intensive care unit(NICU),which is based on the literature review and analysis and the current situation survey,and guided by the knowledge-information and practice theory.The program includes four aspects: training objectives,training contents,training methods,training assessment and evaluation.The training program constructed is normative,systematic and targeted,which can provide practical reference for medical institutions to carry out the pain management training for nurses in neonatal intensive care unit,help improve the pain management ability of nurses in neonatal intensive care unit,and have important significance for preventing and reducing the occurrence of pain stimulation in hospitalized children in neonatal intensive care unit.