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Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination
To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology. Specific intervention strategies ( ., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected...
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Published in: | World journal of clinical pediatrics 2017-02, Vol.6 (1), p.81-88 |
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Main Authors: | , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.
Specific intervention strategies (
., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit. Additionally, self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.
Significant improvements were noted post-intervention. Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received. Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [
(143) = 2.50,
≤ 0.05], as well as greater agreement that the pain prevention strategies used helped their children's pain [
(180) = 2.17,
≤ 0.05] and that they would be willing to use the same strategy again in the future [
(179) = 3.26,
≤ 0.001] as compared to baseline. Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention. Specifically, staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47
3.10;
(70) = -2.11,
≤ 0.05], less agreement that pain from vaccinations is "just part of the process" [3.94
3.23;
(70) = 2.61,
≤ 0.05], and less agreement that parents expect their children to experience pain during vaccinations [4.81
4.38;
(69) = 2.24,
≤ 0.05]. Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas, including safety, cost, time, and effectiveness, as well as less concern about the pain their children experience with vaccination [4.08
3.26;
(557) = 6.38,
≤ 0.001], less need for additional pain prevention strategies [3.33
2.81;
(476) = 4.51,
≤ 0.001], and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40
3.75;
(433) = -2.39,
≤ 0.05].
Quality improvement methodology can be used to help close the gap in imple |
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ISSN: | 2219-2808 2219-2808 |
DOI: | 10.5409/wjcp.v6.i1.81 |