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The nursing research work entitled: Epidemiology and Management of Painful Procedures in Children in Canadian hospitals by Stevens B., Yamada J., Stinson J., et al (2011) seeks to find out the number of painful procedures that are children undergo in different units in the hospitals in Canada. The authors also find out the various methods of pain management interventions that are used reduce the impact of pain on the children. Another aspect the research touches on is the influence that different hospital units have on administration of the pain management procedures. This is indeed an area that is very important in the nursing field. Due to the delicate and uncertain body functions of children, they are most of the time forced undergo some painful procedures which require pain management strategies. This is indeed an area of interest to all the relevant groups and agencies.
The abstract of this research is well written with clear background information of the topic in question. It states the problem that exists and the need to find out the frequency of the painful procedures done on the children, it also shows the need to follow that with the identification of the common pain management procedures used by different hospital units charged with this task (Dowde, 2009).. Methods and the results of the research are well articulated in this abstract section. They very well summarize the findings gotten from the conducted study. The reader is able to find out the whole overview of the research done. The last section gives the interpretation of the whole research depending on the findings gotten.
This paper has a well written abstract that gives findings that are useful in the field of nursing. The findings are important in helping find out the trends of painful procedures done on the children and the strategies that different hospital units put in place to come with to manage the pain. However, it misses the conclusion part in the abstract, knowing very well that that part features at the end of the research paper. It ought to have been included in this opening part. The last part only interprets but in not clear on the conclusion. It is also prudent to mention that this abstract measures with those of others researches that have been done of the same field, for instance, the research done by Carbajal Ricardo, Rousset Andre, Danan Claude, et al (2010) on the Epidemiology and Treatment of Painful Procedures in Neonates in Intensive Care Units.
The authors introduce this paper by first pointing out the fact that many children undergo a lot of painful procedures, something that has been noted to lead to many negative emotional, physiological, and psychological consequences. This introduction also acknowledges the fact that the establishment of the international standard on pain guidelines coupled with a number of researches done on the subject have helped in coming up with better ways of managing procedural pain. It also brings out the fact that totaling eliminating pain in such procedures is impossible, therefore, the only thing required to help out in such situations is an effective pain management.
The problem presented here is the lack of a specified ways of dealing with procedural pain in various hospital units. This is due to the fact that every hospital unit deals with a specific case, thus, the need of coming up with pain management methods that suits the specific cases. In this light, the research therefore seeks to find out the number of times that the children under hospital care undergo painful procedures and the pain management strategies applied in these cases. The role different hospital units play in pain management is also looked to be looked into. The main variable of this research is very clear; pain (Dufault and Sullivan, 2000).
It is worth mentioning that as much as this introduction has tried to point out the purpose of this research, it is short and lacks a number of details. It does not point out the underlying theory that the research is based on. This could have also aided in strengthening this section. The concept could have been mentioned at this stage of the paper to help the reader conceptualize more on what the research entails. It is however noticeable that the references used in this section of the research paper are recent with all of them being done below a time limit of five years. These references are from reliable journal sources like JAMA.
The methodology of this research entails quantitative approach. This is seen in the numerical aspect of the research. The data taken from various units of different hospitals in Canada over 24 hour period is taken and analyzed to find out the results. The large numbers of the children that are targeted for the research also prove this fact (Bernard, 1994). Research nurses that take part in the research are only supposed to collect charts from different hospital units over a four-week period. The children whose data were used were not directly involved in the research, a fact that explains its quantitative approach (Cassell and Symon, 1994). All the involved participants were trained and stationed in different geographical area hospitals with at least four distinct units. The hospital staffs were also briefed on the nature of the research that was undertaken. Research Ethics Board in Toronto had to first give the nod for the research to take place. This was followed by other research boards from other participating hospitals.
The participants of this research entailed children from infancy up to the age of 18. They had to have been admitted for a period of more than 24 hours in the respective units. Any child without the mentioned specifications did not qualify for inclusion. As it has been mentioned above, they were not directly involved in the research, for instance, in the form of interview. The sample was big going by the fact that data had to be collected from different geographical regions in order to get an accurate position of the situation. The fact that all the children sampled were admitted for painful procedures, then the likely hood of pain management methods was high. This could play a role in determining the result of the research.
In the collection of data, the research nurses had to do a thorough analysis of the data provided with details of the children. The procedures that the research nurses were keen on included the skin breaking types (for example: surgery, heel lance, and finger prick) and no-skin breaking (for example: mobilization and sanctioning) (Porter, F., Wolf, C., et al, 1997). As the chart was being reviewed for the latest painful procedures undertaken on the children, the psychological, pharmacologic, or any other physical pain management methods were also reviewed. The research nurses then had the task of entering all the data collected into a web based relational database. This specific built system was made and checked for errors or any omissions to validate it. The method seems to be lacking anything that might have influenced the outcome. This is due to the fact that the research nurses only used the data collected by the hospital staffs.
The analysis of the entered data has been done by statistical method. This was done to find out the main demographic characteristics, the painful procedures done and the strategies to manage the pain. The other calculations done for continous data included means, standard deviations, interquartile ranges and the median. Categorical data was calculated by the use of proportions and the frequency counts (Lohr, S., 1999). In the results, 78.2 (2,987) out of the total 3,822 children analyzed were found to have under gone a painful procedure within the 24 hours of collecting the data. A total of 18,929 painful procedures were reported. Children in the neonatal and pediatric Intensive Care Units registered higher painful procedures that those in surgical and medical units with a median of 10.0 compared to 2.0 in surgical and medical units.
The analysis of the pain management procedures found out that 78.1% (2,334) of the 3,822 children analyzed had received some pain management procedure administered in 24 hours. 1,980 of these children had received at least a form of pharmacologic management. Psychological, physical, and other interventions were administered in the proportion of 584, 609, and 753 respectively. Physical and pharmacologic interventions were mostly used for the children in Intensive Care Units (ICU’s). The results have been well described in this research, with each category being carefully analyzed to ensure that accurate results are found. This is seen in the results of the calculations that include confidence level, skewness and percentages.
The results have effectively showed the results on the current trends on the painful procedures and the subsequent pain management strategies. The study shows that quite a number of children who undergo painful procedures receive some form of pain management method Jacob, E., Puntillo, K., 1999). It also finds out that out the management strategies administered, very few children in the study had specifically applied pain management strategies.
This study has in many ways come up with the contrasting findings to the previous researches done. For instance, Stevens B., Ballantyne M., et al (2010) reports in their research work that non pharmacologic interventions are most frequently used in the ICU’s that the pharmacologic. In this research, it is the opposite. Some of the researchers have also found out that the highest pain management intervention is a combination of both pharmacologic and non pharmacologic (Carbajal Ricardo, Rousset Andre, Danan Claude, et al, 2010).
In conclusion, this research work has been well done with very few errors noticed. Furthermore, the results that are produced mostly contrast the previous works on the same field. The interpretation of the results has been done well but the results may not be very due to a number of factors that were not considered during the data collection. This is the influence of the physicians in administering a specific pain management procedure. This may be a major influence alongside the type of the hospital unit a child is admitted to. All in all the authors have given a good interpretation of their work.
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