NM-214
Assessing Adequacy of Pediatric Resident Teaching for Acute Pediatric Pain Management
Gupta P, Levine Kushner P, Winikoff S
St. Joseph's Regional Medical Center, Jersey City, NJ, USA
Introduction: Untreated pediatric pain has been recognized as a significant cause of morbidity and mortality. The past decade has seen vast improvements in pediatric pain management with the application of evidence based practice guidelines, the formation of dedicated pediatric pain services and the utilization of multimodal treatment methods. Both research and clinical education have enabled these improvements.
The purpose of our study is to assess how comfortable pediatric residents are with acute and post-operative pain management in the pediatric population. Our aim is to create an educational curriculum to bridge any gaps in knowledge elucidated by the results and to develop a pain protocol that can serve as a tool to residents when managing acute and post-operative pediatric pain.
Methods: A survey was sent out to 207 institutions with questions regarding pediatric residents’ frequency of utilizing different approaches to pain management
Results: n=82
How often do you add an additional class of pain medication when a patient is on a PCA?
Always 12.20%
Sometimes 41.46%
Rarely 31.71%
Never 14.63%
How often do you prescribe two different classes of pain medication for a patient?
Always 28.05%
Sometimes 64.63%
Rarely 4.88%
Never 2.44%
How often do you put a patient on a standing order of an NSAID for pain control?
Always 24.39%
Sometimes 62.20%
Rarely 9.76%
Never 3.66%
How often do you utilize or consider blocks or acute pain management?
Always 2.44%
Sometimes 8.54%
Rarely 41.46%
Never 47.56%
Does your hospital have a pain protocol?
Yes 26.83%
No 73.17%
If your hospital does have a pain protocol, how often do you use it?
Always 4.88%
Sometimes 17.07%
Rarely 3.66%
Never 2.44%
N/A 71.95%
Are you comfortable sending patients home with pain medications?
Yes 85.37%
No 14.63%
Discussion: Preliminary results suggest that pediatric residents could benefit from an educational curriculum that highlights the different classes of pain medications and ways in which they can be combined, as well as the types and uses of different regional blocks. Additionally, while pain protocols have become more common, they are not ubiquitous, only 26.8% of those surveyed report having a pain protocol. 78% of residents who have a pain protocol, utilize it; therefore this protocol is a valuable resource in the management of pediatric pain.
Conclusion: As the resources and tools available to us continue to expand, pediatric resident education is vital to the continued improvement in the efficacy of pediatric pain management.
Hannallah RS, Verghese ST. 2010. Acute pain management in children. Journal of Pain Research.3:105-123.
Saroyan JM, Schechter WS, Tresgallo ME, Sun L, Naqvi Z, Graham MJ. 2008. Assessing resident knowledge of acute pain management in hospitalized children: a pilot study. Journal of Pain and Symptom Management. 36(6):628-638.
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