Authors (including presenting author) :
Chow YT (1), Chan TY (1), Chan TY (1), Tsang TH (1), Wong WY (1), Cheng SM (1)
Affiliation :
(1) Department of Paediatrics, Prince of Wales Hospital
Introduction :
Pain associated with peripheral venous or arterial catheterization has been regarded as the most traumatic experience during hospitalization for children in PICU. However, there are several drawbacks regarding to the use of topical anaesthetic agent in Paediatric Intensive Care Unit (PICU) due to its application challenge. Unmanaged pain not only lead to increased distress, but also impede delivery of care. Paediatric patients who fear needles might be uncooperative to undergo further investigations or procedures. Therefore, a quality improvement programme was conducted to address the above-mentioned concern and to improve the quality of care.
Objectives :
1. To review up-to-date and innovative practice for pain reduction
2. To enhance staff awareness and knowledge on pain assessment and management
3. To evaluate the effectiveness of nurse-led music intervention on cannulation related pain in PICU children
Methodology :
A literature review has demonstrated important pain-reducing effects of music therapy in peripheral venous or arterial catheterization. A music program was developed from the evidence-based literature and then a 3-month pilot study was carried out. Education session for nurses was provided prior to the launch of the proposed music program, including age-appropriate pain assessment, implication of music therapy, logistic workflow of the music program. The outcomes were the knowledge improvement of staff after the educational session as showed by the increased score in the pre-test and post-test and the reduction in pain intensity of patients when they were undergoing peripheral venous or arterial catheterization.
Result & Outcome :
After the CQI programme, there was a remarkable improvement in the post-test's performance by staff (n=43) after the education. The average score of the pre-test was 4.79 (± 1.57) while that of the post-test was 9.56 (±0.70). Patient assigned to the control group were having higher pain scores during the catheterization than the music group. The mean peak pain score in the music group (n=10) was 1.5 (± 1.19), while the control group (n=9) took 7.67 (± 1.12). Showing from the project, music therapy may help to alleviate procedure pain in paediatric unit as it was convenient and easy to use. Ongoing education program for pain control on peripheral venous or arterial catheterization is essential to enhance the knowledge assessment and management of pain.
