Hello from Israel

Shalom and WELCOME !!! :)

Can't help you with that but we have some MARVELOUS and wonderful NICU nurses here who I am sure will be able to give you some great info !

Welcome to Allnurses ! :balloons:

Hi and welcome!

On of the nurses in my NICU has just finished her Masters degree and her project was on Infant Pain.

She told us that the best scale is PIPP b/c it is the only one that involves infant gestatonal age.

We are just starting to use it now in my unit so I cant really tell you anything about my own experiance.

Bye iceNICUnurse.....

We use PIPP for that same reason (we have babies from 24 weeks to term). I find it works fairly well, but a lot of the docs don't really care about the scale, they'll order pain meds whenever the nurse feels it is appropriate.

How often do you assess pain ?

At what score do you decide about intervention ?

Do you have policies or protocols for pain control ?

Thank You

We assess pain as often as we do a full assessment on the baby, so it depends on acuity. Usually it is every 4 hours. When to intervene is a matter of some debate as we don't have a definite score, it depends on the doctor. I have noticed that some doctors and nurses are much less concerned about pain than others, so it hasn't standardized our care yet. How pain is treated depends on severety. We start with environment (wrapping the baby, giving them a soother dipped in glucose water or breast milk, lowering the lights and decreasing noise), then we start looking at meds. Unless the situation is one that will obviously need medications, like a chest tube or lp, then we just go straight to the drugs.

What sort of standard procedure do you use?

We are just starting to look into finding an appropriate pain assessment scale. We don`t assess pain as a routine, yet.

When a nurse thinks a baby needs pain meds, she asks the doctor.

We would like to use some scale and build a protocol according to the scores we get.

We use the N-PASS tool and really love it. It's not only easy to use to assess pain, but it also helps determine sedation levels. Gestational age is also taken into consideration.

We check pain scores with every set of vitals signs, whether hands-on or monitored while the baby sleeps. We also check a pain score an hour after any analgesic is administered to see if there was an improvement. Sedation levels are only checked when a baby is handled, as you have to assess how the baby responds to stimulation.

http://www.n-pass.com/index.html