Using the worldwide web to improve children's pain care.
OBJECTIVE
This paper describes a three-year project, the aims of which were to disseminate information regarding the assessment and management of children's pain, to reach consensus on the essential elements of pain assessment for children and to track nurses' perceived changes in pain assessment and management practices in hospital settings over time.


BACKGROUND
Despite the availability of research, guidelines and standards, paediatric nurses inconsistently practice evidence-based pain management. PROJECT METHODS: Nurses attending the 5th International Symposium on Paediatric Pain were invited to a workshop to discuss best practices and consider ways to share information regarding the assessment and management of children's pain. A website was designed and participants provided hospital guidelines, exchanged information via the Internet and completed periodic surveys.


CONCLUSIONS
Web-based resources were positively received. Consensus regarding the essential elements of pain management was achieved, but nurses identified organizational and resource restraints as barriers to achieving best practices. Surveys identified perceived increases in some hospital and ward level resources and activities to improve children's pain care. Sharing of information related to children's pain management and benchmarking of practice should be encouraged. Consensus building and networking may facilitate change, but organizational commitment is also required for successful implementation of new practices.
Bruce
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Clinical Nurse Specialist, Pain Control Service, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. L.Bruce@ich.ucl.ac.uk
Franck
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D032921:Consensus; D005060:Europe; D019317:Evidence-Based Medicine; D019538:Health Care Surveys; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D009656:North America; D010146:Pain / Q000175:diagnosis / Q000451:nursing* / Q000517:prevention & control; D010147:Pain Measurement