title: Pain Outcomes in a US Children's Hospital: A Prospective Cross-Sectional Survey.
abstract: OBJECTIVE
  Pain in hospitalized children may be underrecognized and undertreated. The objective of this survey was to benchmark pain prevalence, intensity, assessment, and pharmacologic as well as integrative treatment of pain in inpatients in a US children's hospital.
  
  
  METHODS
  This was a single-day, cross-sectional survey and electronic medical record review of inpatients who received medical care at a pediatric hospital. Inpatients and emergency department patients were asked to report their experience with pain and its management during the previous 24 hours.
  
  
  RESULTS
  Of 279 inpatients listed on the morning census, 178 children and parents were located and completed the survey. Seventy-six percent had experienced pain during the previous 24 hours, usually acute or procedural pain, 12% of whom possibly suffered from chronic pain. Twenty percent of all children surveyed experienced moderate and 30% severe pain in that time period. The worst pain reported by patients was caused by needle pokes (40%), followed by trauma/injury (34%). Children and their parents rated 5 integrative, nonpharmacologic modalities as more effective than medications. Pain assessments and management were documented in the medical record for 58% of patients covering the 24-hour period before the morning census. The most commonly prescribed analgesics were acetaminophen, morphine, and ibuprofen.
  
  
  CONCLUSIONS
  Despite existing hospital policies and a pain consult team, significant room for improvement in pain management was identified. A hospital-wide, 3-year Lean quality improvement initiative on reducing pain was commenced as a result of this survey.
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota; University of Minnesota Medical School, Minneapolis, Minnesota; stefan.friedrichsdorf@childrensMN.org.
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Friedrichsdorf
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;
authors.forename: Andrea
authors.initials: A
authors.lastname: Postier
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;
authors.forename: Donna
authors.initials: D
authors.lastname: Eull
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;
authors.forename: Christian
authors.initials: C
authors.lastname: Weidner
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;
authors.forename: Laurie
authors.initials: L
authors.lastname: Foster
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;
authors.forename: Michele
authors.initials: M
authors.lastname: Gilbert
authors.affiliation: The Hospital for Sick Children, Toronto, Canada; and University of Toronto, Toronto, Canada.
authors.forename: Fiona
authors.initials: F
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D001294:Attitude to Health; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008910:Minnesota; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D036301:Qualitative Research; D058996:Quality Improvement
chemical_list: D000700:Analgesics
keywords: Lean; audit; children’s hospital; pain; pediatric; quality improvement