title: Neonatal nurses' perceptions of pain assessment and management in NICUs: a national survey.
abstract: OBJECTIVE
  The purpose of this survey was to investigate neonatal nurses' perceptions of knowledge and practice in pain assessment and management.
  
  
  METHODS
  A convenience sample consisted of 237 neonatal nurses with a membership in National Association of Neonatal Nurses (NANN) and neonatal nurses in Connecticut who were not NANN members. A researcher-developed questionnaire, including 36 questions with Likert scale and 2 open-ended questions, was used.
  
  
  RESULTS
  The nurses were knowledgeable, and about 50% felt that they received adequate training and continuing education on pain. Participants reported the use of pain assessment tools (81%) and felt confident in uses of pharmacologic (83%) and nonpharmacologic interventions (79%). More than half felt that the pain tool used in their unit was appropriate for neonates (65%) and was an accurate measure (60%). Fewer than half reported that pain was well managed (44%) and that their pain protocols were research evidence based (43%).
  
  
  CONCLUSIONS
  Nurses' perceptions of well-managed pain were significantly correlated with training, use of appropriate and accurate pain tools, and clear and research-based protocols. Barriers to effective pain management emerged as resistance to change, lack of knowledge, perceived fear of side effects of pain medication and incorrect interpretation of pain signals, lack of time, and lack of trust in the pain assessment tools. Gaps exist in knowledge, evidence, and practice in neonatal assessment and management.
authors.affiliation: University of Connecticut School of Nursing, Storrs.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Cong
authors.forename: Colleen
authors.initials: C
authors.lastname: Delaney
authors.forename: Victoria
authors.initials: V
authors.lastname: Vazquez
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004509:Education, Nursing, Continuing; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000706:statistics & numerical data; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education; D059408:Pain Management / Q000379:methods / Q000451:nursing*; D010147:Pain Measurement / Q000379:methods / Q000451:nursing*; D011795:Surveys and Questionnaires; D014481:United States