title: The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse's assessment of neonates.
abstract: OBJECTIVE
  To determine the reliability of an objective measure of pain, agitation and sedation using the Neonatal Pain, Agitation and Sedation Scale (N-PASS) compared with nursing bedside assessment.
  
  
  METHODS
  Neonates admitted in neonatal intensive care unit over a 6-month period were eligible. Pain and sedation were assessed with N-PASS, and a subjective questionnaire was administered to the bedside nurse.
  
  
  RESULTS
  A total of 218 neonates were eligible (median: gestational age 34.6 weeks, age at assessment 7 days). N-PASS pain score correlated significantly with both nurses' pain score (Spearman coefficient (r)=0.37; P<0.001) and agitation score (r=0.56; P<0.001). N-PASS sedation score correlated with nurses' sedation score (r=-0.39; P<0.001). Adjusting for gestational age, day of life, intrauterine drug exposure and use of high frequency ventilation only slightly attenuated the correlations (r=0.36, 0.55 and -0.31, respectively).
  
  
  CONCLUSIONS
  The N-PASS captures nursing assessment of pain, agitation and sedation in this broad population and provides a quantitative assessment of subjective descriptions that often drives patient therapy.
authors.affiliation: Charlotte Bloomberg Children's Center, Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Hillman
authors.affiliation: Charlotte Bloomberg Children's Center, Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Tabrizi
authors.affiliation: Charlotte Bloomberg Children's Center, Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Gauda
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Carson
authors.affiliation: Charlotte Bloomberg Children's Center, Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Aucott
mesh_terms: D016292:Procedural Sedation / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009730:Nursing Assessment / Q000379:methods / Q000592:standards; D010147:Pain Measurement / Q000379:methods / Q000592:standards; D019095:Point-of-Care Systems; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000628:therapy; D058996:Quality Improvement; D064232:Visual Analog Scale