Venipuncture and intravenous cannulation are among the most common and widespread medical procedures performed on children today. Therefore, effective treatment of venous access pain can benefit from an integrated systems approach that enlists multiple players in the health care system. By using case studies that analyze this issue from the perspective of the nurse, the physician, the pharmacist, and the child life specialist, this article illustrates how multidisciplinary programs designed to manage needle pain have been developed successfully in several institutions. Common themes that arise from these case studies include the importance of a multidisciplinary evidence-based approach to advocate change; a system-wide protocol for the administration of local anesthetics; convenient access to topical local anesthetics; department and hospital-wide support for educational efforts, including training in nonpharmacologic techniques used by child life specialists; and ongoing quantification of the overall success of any program. Implementation of these strategies can result in significant improvements in the pediatric venous access experience.
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November 2008
Supplement Articles|
November 01 2008
On the Front Lines: Lessons Learned in Implementing Multidisciplinary Peripheral Venous Access Pain-Management Programs in Pediatric Hospitals
Sarah Leahy, BA, RN, RSCN;
Sarah Leahy, BA, RN, RSCN
aCenter for Pain Relief, Children's Healthcare of Atlanta, Atlanta, Georgia
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Robert M. Kennedy, MD;
Robert M. Kennedy, MD
bDepartment of Pediatrics, Division of Emergency Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri
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Joy Hesselgrave, MSN, RN, CPON;
Joy Hesselgrave, MSN, RN, CPON
cTexas Children's Cancer Center and Hematology Service, Texas Children's Hospital, Houston, Texas
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Karen Gurwitch, PharmD;
Karen Gurwitch, PharmD
dPharmacy Department, Texas Children's Hospital, Houston, Texas
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Mary Barkey, MA, CCLS;
Mary Barkey, MA, CCLS
eFamily and Child Life Services, Rainbow Babies & Children's Hospital, Cleveland, Ohio
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Toni F. Millar, MS, CCLS
Toni F. Millar, MS, CCLS
eFamily and Child Life Services, Rainbow Babies & Children's Hospital, Cleveland, Ohio
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Address correspondence to Sarah Leahy, RN, RSCN, BA, Center for Pain Relief, Children's Healthcare of Atlanta, 1124 Mayfield Dr, Decatur, GA 30033. E-mail: sal.leahy@choa.org
Pediatrics (2008) 122 (Supplement_3): S161–S170.
Article history
Accepted:
June 04 2008
Citation
Sarah Leahy, Robert M. Kennedy, Joy Hesselgrave, Karen Gurwitch, Mary Barkey, Toni F. Millar; On the Front Lines: Lessons Learned in Implementing Multidisciplinary Peripheral Venous Access Pain-Management Programs in Pediatric Hospitals. Pediatrics November 2008; 122 (Supplement_3): S161–S170. 10.1542/peds.2008-1055i
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