ORIGINAL RESEARCH Pain management in neonates: a survey of nurses and doctors Akuma O Akuma & Sue Jordan Accepted for publication 3 September 2011 Correspondence to S. Jordan: e-mail: s.e.jordan@swansea.ac.uk Akuma O Akuma MBBS MSc MRCPCH Consultant Neonatologist Leicester Royal Infirmary UK Sue Jordan MBBch PhD FHEA Reader College of Human and Health Sciences Swansea University UK AKUMA KUMA A. O.& .& JORDAN ORDAN S. (2011) . (2011) Pain management in neonates: a survey of nurses and doctors. Journal of Advanced Nursing 00(0), 000–000. doi: 10.1111/ j.1365-2648.2011.05837.x Abstract Aim. This paper is a report of a descriptive survey of nurses’ and doctors’ knowl- edge and reported practice regarding procedural pain assessment and management in neonatal intensive care units. Background. There are concerns that pain is often unrecognized and under-treated in neonates. Current guidelines advocate administration of analgesia and comfort measures, but may be vulnerable to inter-professional differences in guideline implementation. Methods. All nurses and doctors working in all seven neonatal intensive care units in one area of the United Kingdom were surveyed between January to August 2007. Lead clinicians distributed and collected anonymous questionnaires. Findings. Response rate was 44% (62 doctors, 137 nurses). Internal consistency was high, overall Cronbach’s alpha 0Æ976. Respondents were knowledgeable, mean score 82% (SD13Æ3%). They agreed that neonates feel pain and need analgesia. Chest drain insertion was perceived to be the most painful procedure, heel-prick the least. Respondents reported that analgesia and comfort measures were not usually administered for most procedures: nurses were more likely than doctors to report adhering to guidelines advocating administration of analgesia and comfort mea- sures. Statistically significant differences between current and optimal practice were acknowledged. Few (21% and 37%) had received training on neonatal pain and fewer (2Æ5%) employed recognized pain assessment instruments. Pain management guidelines were available to 29(47%) doctors and 85(62%) nurses; 20(18%) reported that these had been audited. Conclusion. Clinicians were knowledgeable about neonatal pain, but gaps between knowledge and practice remain. This hiatus could be bridged by providing research evidence for the efficacy of guidelines incorporating validated pain assessment instruments. Keywords: analgesia, comfort measures, doctors, neonates, nurses, procedural pain Introduction Technological advances have facilitated the survival of extremely premature newborns, fostering the evolution of neonatal care as a sub-specialty in developed and developing countries (Horbar et al. 2002). The sick neonate admitted to the neonatal intensive care unit (NICU) undergoes many traumatic and invasive procedures, such as venepuncture, Ó 2011 Blackwell Publishing Ltd 1 JAN JOURNAL OF ADVANCED NURSING