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Neshat H, Aslani K, Jamshidi M, Aslanabadi S, Ghorbani F. Comparison of the Effect of Massage and EMLA Cream on Children's Physiological Indices During Venipuncture: A Factorial Clinical Trial. J Perianesth Nurs 2020; 35:619-624. [PMID: 32782077 DOI: 10.1016/j.jopan.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to identify the effect of massage, EMLA cream, and the combination of these two methods on changes in physiological indices because of pain caused by intravenous line insertion in preschool children. DESIGN A four-group randomized nonblinded clinical trial with factorial design. METHODS In total, 140 eligible 3- to 6-year-old children entered the study in Tabriz Children's Hospital in 2017 and were randomly allocated to four groups (EMLA cream, massage, combination of the two, and control). Physiological responses were measured before and immediately after interventions in all groups. Data were collected and analyzed using SPSS version 19. FINDINGS Comparison of the physiological indices changes caused by pain between groups showed that changes in children's heart rate (HR) and respiratory rate (RR) in the EMLA group and in the combined-method group were statistically significant (P < .05). No significant differences were found in systolic blood pressure and oxygen saturation (SPo2) between the four groups. CONCLUSIONS Results indicated that EMLA cream was more effective than massage and a combination of EMLA and massage in reducing an increase in the HR and RR caused by pain in children. Massage alone was not effective in significantly lowering the children's increased physiological indices such as the HR and RR, and it seems the effectiveness of massage is more noticeable in conjunction with EMLA cream.
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Affiliation(s)
- Hanieh Neshat
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kafiyeh Aslani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Surgery Unit, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Massoud Jamshidi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Surgery Unit, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeid Aslanabadi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Surgery Unit, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ghorbani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Ballard A, Khadra C, Adler S, D Trottier E, Bailey B, Poonai N, Théroux J, Le May S. External cold and vibration for pain management of children undergoing needle-related procedures in the emergency department: a randomised controlled non-inferiority trial protocol. BMJ Open 2019; 9:e023214. [PMID: 30782698 PMCID: PMC6340451 DOI: 10.1136/bmjopen-2018-023214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Needle-related procedures are considered as the most important source of pain and distress in children in hospital settings. Considering the physiological and psychological consequences that could result from these procedures, management of pain and distress through pharmacological and non-pharmacological methods is essential. Therefore, it is important to have interventions that are rapid, easy-to-use and likely to be translated into clinical practice for routine use. The aim of this study will be to determine whether a device combining cold and vibration (Buzzy) is non-inferior to a topical anaesthetic (liposomal lidocaine 4% cream) for pain management of children undergoing needle-related procedures in the emergency department. METHODS AND ANALYSIS This study will be a randomised controlled non-inferiority trial comparing the Buzzy device to liposomal lidocaine 4% cream for needle-related pain management. A total of 346 participants will be randomly assigned in a 1:1 ratio to one of the two study groups. The primary outcome will be the mean difference in pain intensity between groups during needle-related procedures. A non-inferiority margin of 0.70 on the Color Analogue Scale will be considered. A Non-inferiority margin of 0.70 on the Color Analogue Scale will be considered. The secondary outcomes will be the level of distress during the procedure, the success of the procedure at first attempt, the occurrence of adverse events, the satisfaction of both interventions and the memory of pain 24 hours after the procedure. The primary outcome will be assessed for non-inferiority and the secondary outcomes for superiority. ETHICS AND DISSEMINATION This study protocol was reviewed and approved by the institutional review board of the study setting. Findings of this trial will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER NCT02616419.
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Affiliation(s)
- Ariane Ballard
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
| | - Christelle Khadra
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
| | - Samara Adler
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Evelyne D Trottier
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Benoit Bailey
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Naveen Poonai
- Department of Emergency Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Children's Health Research Institute, London Health Sciences Centre, London, Ontario, Canada
| | - Jean Théroux
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
| | - Sylvie Le May
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
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Susam V, Friedel M, Basile P, Ferri P, Bonetti L. Efficacy of the Buzzy System for pain relief during venipuncture in children: a randomized controlled trial. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:6-16. [PMID: 30038198 PMCID: PMC6357594 DOI: 10.23750/abm.v89i6-s.7378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 06/07/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK procedural pain is a significant issue for paediatric patients. In particular, needle pain is amongst the most stressful for children. Studies revealed that a large number of children do not receive adequate pain prevention during the procedures. Neglecting the prevention of needle pain can cause several psychological effects such as anxiety and phobias, and increase perceptions of pain in the future. We aimed to verify the efficacy of Buzzy System in reducing pain during venipuncture. METHODS A randomized control trial was conducted among 72 children aged 3 to 10 years undergoing venipuncture. Children were randomly assigned to The Buzzy with distraction cards group (experimental group) or to "magic gloves" group (control group). Perception of pain was measured through the Visual Analogue Scale (VAS), the Wong-Baker Scale (WBS) and the Numeric Rating Scale (NRS). RESULTS Sixty-four children participated in the study, 34 in the experimental group and 30 in the control group. The experimental group showed significantly lower levels of pain (p=.039; 95% CI: -2,11; -0,06) in terms of the mean=3.65±2.011; median=3, compared to the control group (mean: 4.67±2.14, median=4). Caregivers were satisfied with the Buzzy System. CONCLUSION The Buzzy System combined to distraction cards showed a greater reduction of perceived pain than "magic glove" technique. This study underlines the importance of active involvement of caregivers during procedural pain in children. Pediatric nurses have an important role in empowering children and caregivers to be interactive during venipunctures.
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Affiliation(s)
- Volkan Susam
- General Medical Ward, ASST Monza-San Gerardo, San Gerardo Hospital, Italy..
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Ballard A, Khadra C, Adler S, Doyon-Trottier E, Le May S. Efficacy of the Buzzy® device for pain management of children during needle-related procedures: a systematic review protocol. Syst Rev 2018; 7:78. [PMID: 29788987 PMCID: PMC5964660 DOI: 10.1186/s13643-018-0738-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/01/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Needle-related procedures are the most important source of pain in children in hospital setting. Unmanaged pain could result in short- and long-term physiological, psychological, and emotional consequences. Although the efficacy of numerous interventions has been evaluated, procedural pain management is often suboptimal in children undergoing needle-related procedures. The main objective of this systematic review is to examine the evidence for the efficacy of the Buzzy® device for needle-related procedural pain in children. METHODS An electronic search will be conducted in the following databases: CENTRAL, PubMed, MEDLINE, EMBASE, PsycInfo, and CINAHL. There will be no restriction regarding the language, date of publication, and publication status. Eligible studies will be randomized controlled trials using the Buzzy® device for pain management in children undergoing needle-related procedures. Selection of studies, data extraction and management, assessment of risk of bias and quality of evidence will be performed by two independent reviewers. A third researcher will be consulted in case of discrepancies. Depending on the availability and quality of the data as well as clinical and statistical heterogeneity, a meta-analysis will be performed. Otherwise, findings will be qualitatively reported. DISCUSSION This will be the first systematic review to examine the efficacy of the Buzzy® device on pain management of children during needle-related procedures. Results of this review will guide clinical practice and recommendations for further research to improve procedural pediatric pain management. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017076531.
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Affiliation(s)
- Ariane Ballard
- Faculty of Nursing, University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8 Canada
- CHU Sainte-Justine Research Centre, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
| | - Christelle Khadra
- Faculty of Nursing, University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8 Canada
- CHU Sainte-Justine Research Centre, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
| | - Samara Adler
- Faculty of Medicine, University of Montreal, 2900, boulevard Édouard-Monpetit, Montreal, QC H3T 1J4 Canada
| | - Evelyne Doyon-Trottier
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
| | - Sylvie Le May
- Faculty of Nursing, University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8 Canada
- CHU Sainte-Justine Research Centre, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
- Faculty of Nursing, University of Montreal, P.O. Box 6128, Succursale Centre-Ville, Montreal, QC H3C 3J7 Canada
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Distraction Kits for Pain Management of Children Undergoing Painful Procedures in the Emergency Department: A Pilot Study. Pain Manag Nurs 2017; 18:418-426. [DOI: 10.1016/j.pmn.2017.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 06/22/2017] [Accepted: 08/02/2017] [Indexed: 11/22/2022]
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Prothero MM, Morse JM. Eliciting the Functional Processes of Apologizing for Errors in Health Care: Developing an Explanatory Model of Apology. Glob Qual Nurs Res 2017; 4:2333393617696686. [PMID: 28540337 PMCID: PMC5433672 DOI: 10.1177/2333393617696686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 11/15/2022] Open
Abstract
The purpose of this article was to analyze the concept development of apology in the context of errors in health care, the administrative response, policy and format/process of the subsequent apology. Using pragmatic utility and a systematic review of the literature, 29 articles and one book provided attributes involved in apologizing. Analytic questions were developed to guide the data synthesis and types of apologies used in different circumstances identified. The antecedents of apologizing, and the attributes and outcomes were identified. A model was constructed illustrating the components of a complete apology, other types of apologies, and ramifications/outcomes of each. Clinical implications of developing formal policies for correcting medical errors through apologies are recommended. Defining the essential elements of apology is the first step in establishing a just culture in health care. Respect for patient-centered care reduces the retaliate consequences following an error, and may even restore the physician patient relationship.
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Bahorski JS, Hauber RP, Hanks C, Johnson M, Mundy K, Ranner D, Stoutamire B, Gordon G. Mitigating procedural pain during venipuncture in a pediatric population: A randomized factorial study. Int J Nurs Stud 2015; 52:1553-64. [DOI: 10.1016/j.ijnurstu.2015.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 05/12/2015] [Accepted: 05/14/2015] [Indexed: 12/23/2022]
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Brock DM, Quella A, Lipira L, Lu DW, Gallagher TH. Physician assistants and the disclosure of medical error. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:858-862. [PMID: 24871235 DOI: 10.1097/acm.0000000000000261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Evolving state law, professional societies, and national guidelines, including those of the American Medical Association and Joint Commission, recommend that patients receive transparent communication when a medical error occurs. Recommendations for error disclosure typically consist of an explanation that an error has occurred, delivery of an explicit apology, an explanation of the facts around the event, its medical ramifications and how care will be managed, and a description of how similar errors will be prevented in the future. Although error disclosure is widely endorsed in the medical and nursing literature, there is little discussion of the unique role that the physician assistant (PA) might play in these interactions. PAs are trained in the medical model and technically practice under the supervision of a physician. They are also commonly integrated into interprofessional health care teams in surgical and urgent care settings. PA practice is characterized by widely varying degrees of provider autonomy. How PAs should collaborate with physicians in sensitive error disclosure conversations with patients is unclear. With the number of practicing PAs growing rapidly in nearly all domains of medicine, their role in the error disclosure process warrants exploration. The authors call for educational societies and accrediting agencies to support policy to establish guidelines for PA disclosure of error. They encourage medical and PA researchers to explore and report best-practice disclosure roles for PAs. Finally, they recommend that PA educational programs implement trainings in disclosure skills, and hospitals and supervising physicians provide and support training for practicing PAs.
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Affiliation(s)
- Douglas M Brock
- Dr. Brock is associate professor, University of Washington Department of Family Medicine and MEDEX Northwest, Seattle, Washington. Dr. Quella is lecturer, University of Washington Department of Family Medicine and MEDEX Northwest, Spokane, Washington. Ms. Lipira is research scientist, University of Washington Department of Medicine, Seattle, Washington. Dr. Lu is assistant professor, Northwestern University, Department of Emergency Medicine, Chicago, Illinois. Dr. Gallagher is professor, University of Washington Department of Medicine, Seattle, Washington
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