Newborn babies face a postcode lottery for pain management
More than half of neonatal units lack a pain relief protocol and many staff are performing painful procedures on newborns without routine analgesia, research has shown.
Only four in 10 neonatal units have a formal policy on pain relief, according
to a postal survey of nurses and doctors working in 214 hospitals in
the UK. Lumbar puncture is performed without analgesia in 55 per cent
of neonatal units and only 45 per cent routinely use analgesia for chest
drain insertion.
For minor procedures such as venepuncture or heel pricks, the majority
of units do not provide routine pain relief. Reasons for withholding
analgesia include uncertainty about safety and dosage, lack of evidence,
a feeling that pain relief is unnecessary for newborns, and professional
culture.
The findings were presented last week at a conference held by the premature
baby charity, BLISS. Julie Robins, advanced neonatal nurse practitioner
at James Cook University Hospital in Middlesbrough, conducted the survey.
She said: “Pain management is often neglected or seen as an optional
extra in neonatal care. I wonder how many of us [as adults] would like
to have these procedures without any analgesia.’’
Sharon Conroy, lecturer in paediatric
clinical pharmacy at the University of Nottingham, commented that lack
of evidence and suitable formulations are some of the difficulties that
pharmacists face. However, she believes pharmacists can alert teams to
latest developments and speak out as patient advocates. “If we
are familiar with treatments that could make those interventions more
comfortable then we should be more proactive in pushing the unit to do
it,” she said. |
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