Nurses' perceptions of pain assessment and management practices in neonates: a cross-sectional survey.

Aims: This study aimed to describe pain assessment and management practices for neonates based on nurses' perceptions in neonatal intensive care units (NICUs).

Design: A descriptive cross-sectional survey was conducted in Finland.

Methods: Of all nurses (N = 422) working in the NICUs in the country's five university hospitals, 294 responded to a questionnaire. The data were analysed by statistical methods.

Results: Nurses agreed that pain assessment is important, but over half of them reported being able to assess pain in a reliable way without using pain assessment scales. Physiological parameters and changes in neonate's behaviour were reported as routinely observed, but many specific facial expressions indicative of pain were less often observed. Only a few pain assessment scales were known, and they were not routinely used in clinical practice. Most nurses reported using physical methods and giving oral sucrose along with non-nutritive sucking. Counselling parents to continue breastfeeding or guiding them to use skin-to-skin care or music was rarely reported as used to alleviate infants' pain.

Conclusions: Educational interventions for nurses are needed to improve pain assessment and management practices in the NICUs. In addition, there is a need for national guidelines in order to ensure the equal treatment to all neonates.