Oral Themed Presentation


Evaluating the use of Non-Pharmacological Pain Management Strategies on Neonates using Simulation

Tuesday, May 15
13:30 - 15:00
Location: Neptune 1&2

Abstract : Background
There is increasing evidence that the provision of high quality developmental care results in better long term neurodevelopmental outcomes for preterm babies in NICU’s. This includes the use of non-pharmacological pain management strategies during invasive procedures, such as swaddling, sucrose and comfort holding. Evidence also suggests that preterm babies who are exposed to a higher number of invasive or pain-related procedures, have long term abnormalities in their white matter microstructure, score lower on cognitive tests at school age and have altered physiological responses., We propose that medical staff have little or no training in the use of non-pharmacological pain management strategies and there is an educational need in this area.

Proposed Approach to Assessing the Educational Need
Through a simulated scenario of a preterm baby requiring a cannula and blood samples, we intend to evaluate the use of non-pharmacological pain management strategies by medical staff on a tertiary neonatal unit. We will assess the performance of the procedure using the Evaluation of Intervention (EVIN) Scale, which is a validated scale specifically designed for this purpose. We will follow this up with a questionnaire to assess exposure to developmental care training. We have started assessments and thus far candidates are showing mostly intermediate or worst practise on the applicable points of the EVIN scale and the questionnaire is revealing that no one has had formal training in developmental care.

Discussion - Addressing the Educational Need
We intend to deliver a video training package in the use of pain management strategies and re-evaluate the performance of the medical staff for the same simulated scenario to assess the impact of the educational tool. We hope that by addressing this knowledge gap we can make behavioural change and improve the use of non-pharmacological pain management strategies and developmental care in our neonatal unit.

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2. Brummelte S, Chau CM, Cepeda IL, Degenhardt A, Weinberg J, Synnes AR, Grunau RE. Cortisol levels in former preterm children at school age are predicted by neonatal procedural pain-related stress. Psychoneuroendocrinology 2015; 51:151-163
3. Vinall J, Miller SP, Bjornson BH, Fitzpatrick KP, Poskitt KJ, Brant R et al. Invasive procedures in preterm children: Brain and cognitive development at school age. Pediatrics 2014; 133(3):412–421.
4. Warren I, Hicks B, Kleberg A et al. The validity and reliability of the EValuation of INtervention Scale (EVIN): Preliminary report. Acta Paediatrica 2016; 105(6): 618-622

Isobel Fullwood, MBChB MRCPCH

Paediatric Simulation Fellow
Birmingham Women's Hospital, Birmingham

Dr Isobel Fullwood MBChB MRCPCH, I am a Paediatrics trainee based in the West Midlands, UK and have taken an out of programme year working as a Simulation Fellow for the Birmingham Women's and Children's NHS Foundation Trust, which involves running multidisciplinary simulation sessions in a variety of clinical areas including NICU, PICU, general paediatrics and the emergency department.


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Ashley D. Holt, MBChB BMedSc MRCPCH

Paediatric Simulation Fellow
New Cross Hospital, Wolverhampton
Birmingham, England, United Kingdom

Dr Ashley Holt - MBChB, BMedsc (Healthcare Ethics and Law)
Ashley is a Paediatric Simulation Fellow working at New Cross Hospital in the West Midlands region of the United Kingdom. The post is in its third year and has been presenting work both nationally and internationally during that time. Ashley is currently in Paediatric training in the West Midlands and became interested in simulation as a candidate when seeing the benefits it brought to the team and how it combined with existing interests in education. Other areas of interest include General Paediatrics and inter-speciality working. He is undertaking a Postgraduate Certificate in Healthcare Simulation at the University of Birmingham to supplement the Simulation Fellow post.


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Gemma Holder, MBChB, MRCPCH, MSc (Paeds)

Consultant Neonatologist
Birmingham Women's Hospital


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Matthew L. Nash, MBChB MRCPCH

Consultant Neonatologist
Birmingham Women's and Children's Hospital
Birmingham, England, United Kingdom


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Evaluating the use of Non-Pharmacological Pain Management Strategies on Neonates using Simulation


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