Promotion of Neonatal Pain Management in Neonatal Intensive Care Unit: A participatory Action Research

Pain management is especially important for infants who are not able to verbally express their pain. The objective of this study was to promote pain management in Neonatal Intensive Care Unit (NICU). The present study was conducted using an action research based on Kemmis and McTaggart’s action research cycle on 35 participants including nurses, physicians, and center managers involved in the care of neonates. Four qualitative methods including interviews, focus group discussions, strategic meetings, and field notes were used for data collection. The content analysis approach was also used to analyze the data. Two action cycles were designed, with four stages of “identification, planning, implementation, and observation and reflection”. Based on the results of this study, the source of the challenges was categorized into four areas of human resources management, pain control policy, workplace conditions, and management factors. The steps for the follow-up and implementation of the proposed solutions and strategies included training workshops, preparation of pain control policy, provision of facilities and equipment, and participation of senior managers in the implementation of neonatal pain management. The results of data analysis in the final evaluation revealed two themes of “comfort” and “improvement” in pain management in the NICU. The results of this study showed positive experiences of the participants on implementation of pain management in the NICU. The results also demonstrated that pain management problems in NICU can be reduced, without imposing high costs, by forming multidisciplinary teams and engaging various disciplines in the process of neonatal pain management.