Decision-making processes used by pediatric and neonatal intensive care unit nurses in medicating infants for postoperative pain

Neonatal and pediatric intensive care unit nurses from two Intermountain West referral centers participated in a study to discern decision-making processes in administering analgesics to postoperative infants. The study utilized a qualitative questionnaire involving clinical scenarios regarding medication practices. Patient medication records were reviewed to discover the trends of medication administration practices for postoperative infants in the previous year. The results of the study demonstrated no influence of demographic variables on the assessment or treatment of pain in infants and few differences between neonatal and pediatric intensive care unit nurses' philosophies or practices. Work experience was identified as the major influence over analgesic administration. Nurses identified crying as the major indicator of pain in infants. Eighty percent of nurses share the goal of pain relief and 67% choose to administer analgesics as their first action after making the diagnosis of pain. Confusion exists regarding analgesia and sedation. Needs for nursing education are identified.