Problem

Hospitalized infants experience an average of 7 painful procedures per day, often without adequate pain treatment.

Globally, hospitalized infants experience an average of 7 painful procedures (ranging from 2 to 17) per day. These procedures commonly include heel lancing, venipuncture or immunization. Although evidence-based strategies to assess and treat pain exist they are not always used. Therefore, the issue is not the lack of knowledge on pain prevention and relief in infants but rather how to apply that knowledge in practice.

Solution

We developed, implemented and evaluated the ImPaC Resource, a behavioral change process that addresses the persistent knowledge-to-practice gap in procedural pain in infants.

ImPaC is a multifaceted, online, standardized 7-step process that takes a small group of change agents through:

• assessment of their unit's readiness for change

• auditing current pain assessment and management practices

• selecting an evidence-based practice change

• defining an aim statement

• implementing change tools from a library of resources

• re-auditing pain practices

• planning next steps

Evaluation of ImPaC has demonstrated improvement of pain practices (i.e., reduced frequency of painful procedures, increased pain assessment and pain management practices) in neonatal units that implemented ImPaC. Better pain practices were observed in units that implemented the full 7-step process. Users considered ImPaC of high quality and evidence-based, well designed, and easy to navigate.