Identify Your Research Focus

Sample Answer

Pain Management

Effective management of pain in pediatrics is one of the challenges that healthcare providers experience in their practice. The challenge arises from the inability of the pediatrics to express their subjective experiences of pain as well as the standardization of pain management methods in healthcare. Pharmacological methods are largely utilized in the management of pediatric pain. However, the use of non-pharmacological interventions remains largely unexplored in the clinical settings. Therefore, the proposed study aims at investigating whether the use of non-pharmacological pain management methods in pediatrics will result in better pain management when compared to its no use in the pediatric setting.

Selected Issue

The selected issue for the proposed research is pain management among pediatrics. According to Pope et al. (2017), pain refers to an unpleasant sensory as well as emotional experience that can cause actual or potential damage to tissues. Pain is among the health issues facing most of the pediatric population. Quantifying the severity of pain in pediatrics is a common challenge that healthcare providers experience in their practice. This challenge arises from the fact that there exists a general misinterpretation of pain outcomes among this population due to a lack of declarative memory of painful experiences. Consequently, there is prevalent unmanaged or mismanagement of pain in pediatric patient population (McNair et al., 2019).

The provision of care to pediatric patients in the hospital setting often exposes them to pain. For instance, painful procedures such as insertion of intravenous lines, dressing, and drawing samples for lab works predisposes the pediatrics to significant levels of pain. According to Dastgheyb et al. (2018), pain has negative outcomes to the health of the pediatric patients. In this case, repeated exposure as well as untreated pain increases the risk of behavioral and neurodevelopmental damage. Persistent, untreated pain also affects the quality of life, mental functioning, and physical functioning of the pediatric patients.

Over time, the changes in the nervous system alongside the cognitive and psychological impacts of pain make conceptualization of pain in this population as a distinct disease entity (Bergomi et al., 2018). Consequently, it increases the need for the adoption of nursing interventions that will increase the optimization of pain management in pediatric populations in the clinical settings. Most importantly, nurses should play a proactive role in exploring the best interventions that can be used to minimize pain in this population.

Problem Statement

As shown above, pain is a common debilitating health problem facing a majority of hospitalized pediatric patients. The pain can be either acute or chronic pain. Acute pain is a physiological response to thermal, noxious, or mechanical stimulus. It may arise due to clinical procedures such as surgery and physical interventions that include wound dressing. Chronic pain on the other hand, refers to irritable pain that can exist for at least three months despite the provision of adequate and appropriate treatment (Akgül et al., 2020). Irrespective of the type of pain, its poor management results in undesired health outcomes such as psychological and developmental challenges.

Generally, the treatment of pediatric pain is achieved with the use of pharmacological interventions. For instance, opioids are largely used in the treatment of pain associated with procedures such as venipuncture in pediatrics. However, the use of these medications is only limited to invasive procedures (Wren et al., 2019). Similarly, there are increasing concerns about the undesired health effects of the pharmacological interventions that are used in managing pain in pediatrics. For example, while the use of morphine in treating chronic pain is effective, it is associated with adverse health outcomes such as dependency and increased risk of depression of the respiratory centers.

Non-pharmacological interventions of pain management in pediatrics have been shown to be effective when compared to pharmacological interventions. Accordingly, non-pharmacological interventions are perceived to be safe, cheap, and effective analgesia in cases of short or minor procedures. Non-pharmacological interventions that are utilized in managing pain among pediatrics include distraction, breastfeeding, guided imagery, hypnosis, and therapeutic touch (https //sci-hub.se/10.1016/j.pedn.2018.04.011 ). Despite their effectiveness in managing pain, their utilization remains largely unexplored in the clinical setting. Most of the healthcare providers also do not advocate its use due to low level of awareness among them. Therefore, it is important that the utilization of non-pharmacological interventions in managing pain among pediatrics be explored to determine its effectiveness over pharmacological methods.

Research Question

The proposed PICOT question for the research will be as follows In pediatric patients, does the use of non-pharmacological pain management interventions result in better pain management when compared to non-use when performing procedures?

Dependent and Independent Variables

The dependent variable in the above research question is better pain management. It is the dependent variable because it is the outcome of the research. The independent variables include non-pharmacological pain management methods such as distraction, therapeutic touch, and hypnosis. It also includes the characteristics of the patient such as age, sex, disease process, and previous subjective experiences with the healthcare providers. These factors are independent variables because they can be manipulated to influence the outcomes of the research.

Stakeholders

The proposed research will involve a number of stakeholders. One of them will be the nurses working in the pediatric unit. The nurses will be involved in the direct implementation of the clinical intervention. They will teach the mothers on ways of implementing the use of non-pharmacological interventions for pain management (Ramira, Instone, & Clark, 2016). They will also determine the effectiveness of the methods used to implement the intervention.

Their input in the evaluation process will be important since they work with the mothers of the children in implementing the proposed intervention. The other group of stakeholders will be the mothers or guardians of the children in the pediatric unit. The mothers and guardians will be involved in the implementation of non-pharmacological interventions for pain management. They will also be involved in determining the effectiveness of the intervention in managing pain experienced by their children. Therefore, they will need to be empowered on the ways of ensuring effective implementation of the proposed intervention.

The other group of stakeholders that will be involved in the research is the nurse managers of the hospital. The success of the project will depend largely on the support provided by the nurse managers. They will lead the implementation of the project. They will also monitor the implementation process and provide feedback on the improvements that need to be embraced for the success of the research. Further stakeholders will be the human resource manager. These personnel will be tasked with the responsibility of determining the resource needs of the project. They will guide the implementation of the most efficient methods of optimizing the outcomes of the research. Therefore, these personnel will be actively involved in all the activities of the research to ensure its success.

Cost Implications

The implementation of the proposed research will demand the use of organization’s resources. This will include human and financial resources. Successful implementation of the research will demand that those involved in it are trained. The nurses need to be trained on the ways to implement the intervention successfully in their setting. They also need to be trained about the metrics that will be used to determine whether the implementation process is a success or not (Halm et al., 2018). The nurses will also be trained on the ways of imparting the right knowledge and skills to the mothers of the children in the pediatric unit. Therefore, it is expected that training will increase the effectiveness of the interventions that will be used to facilitate the success of the project.

The project also requires materials for its success. The materials will include posters, printing materials, and projectors. The other resource that will be needed is time. It is expected that the assessment, planning, implementation, monitoring, and evaluation will take approximately nine months. This will allow for the determination of the effectiveness of the proposed intervention in managing pain among pediatric patients. The other resource that will be needed is labor. The hospital will have to hire an expert in the use of non-pharmacological interventions in pediatric pain management. The expert will train, mentor, and monitor the implementation of the intervention. Consequently, it is important that the hospital provides adequate support for the success of this research.

Conclusion

In summary, effective management of pain in pediatrics is important for the promotion of the health and wellbeing of the children. Pain has adverse outcomes to developmental, social, psychological, and physical wellbeing of the pediatrics. Nurses have the role of ensuring that care interventions that optimize the health outcomes of the pediatrics is provided. This includes exploring the alternative methods of pain management in this population. Therefore, the proposed intervention seeks to explore the effectiveness of non-pharmacological interventions of pain management when compared to lack of its use in pediatric patients.

References

• Akgül, E. A., Karahan, Y., Başoğlu, F., Oğul, A., Öztornaci, B. Ö., Yetim, P., & Sari, H. Y. (2020). Effects of watching cartoons on pain scores in children undergoing venepuncture. Nursing children and young people, 32(1).
• Bergomi, P., Scudeller, L., Pintaldi, S., & Dal Molin, A. (2018). Efficacy of non-pharmacological methods of pain management in children undergoing venipuncture in a pediatric outpatient clinic a randomized controlled trial of audiovisual distraction and external cold and vibration. Journal of pediatric nursing, 42, e66-e72.
• Dastgheyb, S., Fishlock, K., Daskalakis, C., Kessel, J., & Rosen, P. (2018). Evaluating comfort measures for commonly performed painful procedures in pediatric patients. Journal of Pain Research, 11, 1383.
• Halm, M. A., Alway, A., Bunn, S., Dunn, N., Hirschkorn, M., Ramos, B., & Pierre, J. S. (2018). Intersecting evidence-based practice with a lean improvement model. Journal of nursing care quality, 33(4), 309-315.
• McNair, C., Yeo, M. C., Johnston, C., & Taddio, A. (2019). Nonpharmacologic management of pain during common needle puncture procedures in infants Current research evidence and practical considerations An update. Clinics in perinatology, 46(4), 709-730.
• Pope, N., Tallon, M., McConigley, R., Leslie, G., & Wilson, S. (2017). Experiences of acute pain in children who present to a healthcare facility for treatment a systematic review of qualitative evidence. JBI database of systematic reviews and implementation reports, 15(6), 1612-1644.
• Ramira, M. L., Instone, S., & Clark, M. J. (2016). Quality Improvement. Pediatric Pain Management An Evidence-Based Approach. Pediatric nursing, 42(1).
• Wren, A. A., Ross, A. C., D’Souza, G., Almgren, C., Feinstein, A., Marshall, A., & Golianu, B. (2019). Multidisciplinary pain management for pediatric patients with acute and chronic pain a foundational treatment approach when prescribing opioids. Children, 6(2), 33.