Measures and Effects of Pain Management for Wound Dressing Change in Outpatient Children in Western China

Abstract

Yujie Wu,1 Yong Zhao,2 Guangyan Lin,3 Manoj Sharma,4 Yan Wang,1 Liping Chen,1 Liping Wu1 1Department of Nursing, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China; 2School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Outpatient Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Environmental & Occupational Health, University of Nevada, Las Vegas, NV, USACorrespondence: Liping WuDepartment of Nursing, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People’s Republic of ChinaTel [phone]Email [email protected]: The present study investigated the pain management of wound dressing change in outpatient children in western China, and the results may provide a reference to improve the pain management of wound dressing change.Methods: A cross-sectional survey was performed to investigate the pain management of wound dressing change in outpatient children in western China. A total of 47 hospitals were selected via convenience sampling, and the pain management organization systems, concrete measures and barriers to adequate pain management of these hospitals were investigated.Results: More than 70% of these hospitals had established pain management systems, analgesic drug management norms and wound care teams. Nurses were the primary providers for wound dressing change in 48.94% of the hospitals. The assessment, documentation or health education of the pain was not standard in 46.81% of the hospitals. Drug and non-drug analgesia measures were used in most hospitals, however, children did not receive adequate analgesia in 70% of the hospitals. Ibuprofen (30.49%) and lidocaine (29.27%) were commonly used analgesic drugs, and distraction (43.01%) was commonly used as a non-drug analgesia measure. The top three barriers to adequate pain management were medical staff lacking analgesic knowledge (82.98%), family members refusing to use analgesics (61.70%) and low compliance of children (55.32%).Conclusion: The concrete measures for the management of wound dressing pain in children are not standardized, and the analgesic effect is poor. In order to improve the pain management of children, Standardized procedures for pain management (pain assessment, analgesia measures, pain documentation and health education) should be strictly followed during wound dressing change, and the identified barriers should be addressed.Keywords: pain management, wound care, children

Keywords

• pain management
• wound care
• children