Nipps, Pipps, N-pass....

[prmenrs, RN]

re-evaluating our flow sheet, including the pain scale.

does anyone use a pain scale other than nipps, pipps, or n-pass?

thanks for your help!!

[dawngloves, BSN, RN]

We use CRIES. It is almost useless in a NICU if you ask me.

[2curlygirls]

We use N-PASS but used to use PIPP which was awful IMO...Oh we also use FLACC

[prmenrs, RN]

Dawn: I couldn't find a website for "CRIES"---do you have one? The FLACC one seems for older infants?

Thanks for your help everybody!! :flowersfo

[BabyNurse513]

http://72.14.207.104/search?q=cache:Aple_xz-_PoJ:painconsortium.nih.gov/pain_scales/CRIESPainScale.pdf+CRIES+pain+scale&hl=en&gl=us&ct=clnk&cd=2

Hopeully that will work. I have used the CRIES scale in all 3 of the NICU's I have worked in. At my current one we also use FLACC on our older babies.

[elizabells, BSN, RN]

Disclaimer: still a student, but I've been doing a full-time preceptorship in the NICU for the last seven weeks.

Never seen a pain scale used. Ever. We do medicate for pain, but I haven't seen a pain scale. This is a level III, rated number 5 out of the whole country.

[BittyBabyGrower, MSN, RN]

There has to be a pain scale somewhere...it is a big thing with JCH.

We use N-PASS, we used cries and it sucked with the little kids and had nothing to do with sedation. With the N-PASS you have to keep track of corrected age, which we do on our flowsheets.

[elizabells, BSN, RN]

There has to be a pain scale somewhere...it is a big thing with JCH.

We use N-PASS, we used cries and it sucked with the little kids and had nothing to do with sedation. With the N-PASS you have to keep track of corrected age, which we do on our flowsheets.

We have a "comfort assessment" tool in the computer that looks at corrected age, BP and HR changes with handling, and facial expression. Maybe that's it.

[BittyBabyGrower, MSN, RN]

That's probably it...you have to be able to score to administer pain/sedation meds

[elizabells, BSN, RN]

That's probably it...you have to be able to score to administer pain/sedation meds

Now, for that, we just pick a number (1-3, 4-7, 8-10) when we sign out the med. The comfort assessment is done q3 with vitals and feedings. That's in THEORY, I seem to be one of the only ones who does it more than qshift.

[Gompers, BSN, RN]

Now, for that, we just pick a number (1-3, 4-7, 8-10) when we sign out the med. The comfort assessment is done q3 with vitals and feedings. That's in THEORY, I seem to be one of the only ones who does it more than qshift.

We had trouble getting people to chart pain scores at first, too. We were doing it only with vital signs (Q1-4H depending on baby's condition) and then were supposed to chart another pain score an hour after giving pain meds. People couldn't seem to remember to do it. What we ended up doing was revamping our flow sheet and included it in the section where we do hourly checks - it's right next to the O2 sats and color assessement. These boxes are shaded pink instead of white like the rest of the sheet, so it's an extra reminder that we need to fill in those colomns every hour. Worked like a charm, and all of our babies get pain scores Q1H now - even those grower-feeders. We do it for everyone. Plus when we handle the baby, we also give them a sedation score to assess how they react to stimulation. This is using the N-PASS scale. Pain scores are positive numbers, sedation is negative numbers.

[prmenrs, RN]

It's on our flow sheet, too, along w/a box that shows the tool (@ present, PIPPS). Since we're revising the flowsheet, we can change that part.

I'm hoping we'll select N-PASS. I really believe it's the most appropriate.