title: Implementation and case-study results of potentially better practices to improve pain management of neonates.
abstract: OBJECTIVE
  Collaborative quality improvement techniques were used to facilitate local quality improvement in the management of pain in infants. Several case studies are presented to highlight this process.
  
  
  METHODS
  Twelve NICUs in the Neonatal Intensive Care Quality Improvement Collaborative 2002 focused on improving neonatal pain management and sedation practices. These centers developed and implemented evidence-based potentially better practices for pain management and sedation in neonates. The group introduced changes through plan-do-study-act cycles and tracked performance measures throughout the process.
  
  
  RESULTS
  Strategies for implementing potentially better practices varied between centers on the basis of local characteristics. Individual centers identified barriers to implementation, developed tools for improvement, and shared their experience with the collaborative. Baseline data from the 12 sites revealed substantial opportunities for improved pain management, and local potentially better practice implementation resulted in measurable improvements in pain management at participating centers.
  
  
  CONCLUSIONS
  The use of collaborative quality improvement techniques enhanced local quality improvement efforts and resulted in effective implementation of potentially better practices at participating centers.
authors.affiliation: Division of Neonatology, Woman's Hospital, Baton Rouge, Louisiana, USA. trey.dunbar@infamedics.com
authors.forename: Alston E
authors.initials: AE
authors.lastname: Dunbar
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Sharek
authors.forename: Nick A
authors.initials: NA
authors.lastname: Mickas
authors.forename: Kara L
authors.initials: KL
authors.lastname: Coker
authors.forename: Jill
authors.initials: J
authors.lastname: Duncan
authors.forename: Debra
authors.initials: D
authors.lastname: McLendon
authors.forename: Claire
authors.initials: C
authors.lastname: Pagano
authors.forename: Teresa D
authors.initials: TD
authors.lastname: Puthoff
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Reynolds
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Powers
authors.forename: C Celeste
authors.initials: CC
authors.lastname: Johnston
mesh_terms: D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000627:therapeutic use; D017144:Focus Groups; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods; D011785:Quality Assurance, Health Care; D012121:Respiration, Artificial; D013395:Sucrose / Q000008:administration & dosage; D013549:Sweetening Agents / Q000008:administration & dosage; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D013549:Sweetening Agents; D013395:Sucrose