The effect of collaborative quality improvement for neonatal pain management in neonatal intensive care units by comparing between attending times

Abstract

The purpose of this study was to verify the sustained effect of the collaborative quality improvement for neonatal pain management on neonatal intensive care units (NICUs) by comparing the rate of the implementation rates of the quality indicators (QI) of neonatal pain in NICU between attending first time group (FG, n=5) and attending twice group (TG, n=3). We used the Jonckheere's trend test or Cochran-Armitage test to examine the changes in QI implementation among both groups over time (ie, at baseline, 3months, 6months, 9months, 12months), three QIs were significant in the FG and one QI was significant in the TG. At 12 months, the number of QIs which were over 85% of the implementation rate was 10 items in the TG, but same one was one item in the FG. The baseline pain management data from the TG revealed the all NICU in the group had introduced pain assessment tools, and developed electronic medical record forms to capture pain score, interventions, and reassessment infant pain. While only two NICUs among the FG had introduce pain assessment tool, no units had developed electronic medical records regarding pain management. This study showed the effect of the collaborative quality improvement for neonatal pain maintained among the NICUs attending second through non-participating period.