REDESIGNING A CARE-PROCESS
A MULTIDISCIPLINARY APPROACH OF PAIN IN CHILDREN IN A GENERAL HOSPITAL

Tjon A Ten, W. 1, Groeneveld, J.1

1 St. Joseph Hospital, Veldhoven, The Netherlands

 

Objective: In St. Joseph Hospital, located in Veldhoven, the Netherlands, a group of healthprofessionals, developed a guideline how to work with children in pain in a general hospital. The guideline is applicable to all children in the hospital from 0 to 16 years of age.

When the guideline was designed the following national guidelines were consulted:

-            Acute pain in children (CBO, institute for quality in healthcare) 1993

-            Nursing care and pain (CBO, institute for quality in healthcare) 1994

-            Guideline; children in pain (VVKV; Dutch association for pediatric nurses) 1997

Methods: In the designing of the guideline, the steps described in  the ‘Business Process Redesign method were followed. These are:

1.         Describe the present situation

2.         Make an inventory about the wants and don’t wants for the future situation

3.         Describe the optimal situation for the future

4.         Implement the new guideline.

This method also includes a measurement of the present and the future. Much attention was also paid to the role and the wishes of all healthprofessionals in order to create as much support for the guideline as possible. The guideline furthermore highlights the importance of;

-            The nurse as a spider in the web of care

-            The role of the parents

-            Painmeasurement and painevaluation

-            Non-pharmacological pain reduction methods

-            Training all healthprofessionals involved in the care of children

Results: The results of implementing the new guideline are:

-            Healthprofessionals are more aware of pain in children.

-            The knowledge of when a child is in pain increases by painmeasurement and

-            painregistration.

-            Painmeasurement is included in the daily care

-            Patient satisfaction in relation to paintreatment has improved

-            Interrater variability has improved 3 months after implementation of the

-            guideline.

Conclusions: When children are in pain, they may be unwilling to cooperate and this may delay the healingprocess. By following the guideline, unnecessary pain in children is avoided and the quality of care is improved.

 
 
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