Competency, compassion and contentment: Nurses' attitudes toward pain associated with peripheral venous access in pediatric patients

Peripheral venous access procedures are a major source of pain, anxiety, and distress in pediatric patients. Many children state that such procedures are the worst aspect of their hospital stay. Despite emerging data and guidelines, inadequate attention has been paid to this subject. Understanding nurses' attitudes toward needle-stick pain could help identify opportunities to close treatment gaps, thus enhancing patient and staff satisfaction. We conducted a survey to assess nurses' attitudes regarding the management of procedural pain in pediatric patients. The online survey was administered to a national sample of nurse participants via an emailed invitation to the membership of the Emergency Nurses Association, the Infusion Nurses Society, and the Society of Pediatric Nurses. Participants were asked to rate the importance of managing needle-stick pain, the impact that the needle-stick procedure has on a patient's and nurse's satisfaction, and their beliefs in the value of available pharmacologic and non-pharmacologic interventions. A total of 2188 nurses completed the survey. Results show that improved pain management increases nurses' job performance (>90%), correlates with improved job satisfaction (81%), and improves the hospital experience for children and their families (97%). Only 14% of nurses surveyed feel their needle-stick skills are sufficient to not warrant pain management interventions. Non-pharmacological techniques were deemed somewhat useful but insufficient when used alone. Pharmacologic interventions were used only 29% of the time, owing to limitations associated with the agents available at the time the survey was conducted (ie, slow acting; vasoconstriction); yet 72% of patients were said to experience distress and anxiety without a topical local anesthetic. Inadequate needlestick pain interventions negatively impact the hospital experience for nurse, patient, and family. The use of non-pharmacologic interventions and pharmacologic options that do not cause treatment delays or vasoconstriction would benefit all constituents.

Supported by a grant from Anesiva.