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barriers, infant, neonatal intensive care unit, newborn, nurses, pain, pain management



  1. Byrd, Patricia J. MSN, RN


PURPOSE: To explore barriers that NICU nurses face when attempting to optimally manage newborn pain.


SUBJECTS: Ninety California NICU nurses with current membership in the National Association of Neonatal Nurses (NANN) voluntarily participated.


DESIGN: A descriptive survey study.


METHODS: A researcher-developed survey consisting of 37 questions was mailed to 300 NICU nurses; 102 were returned and 90 were usable. Probability sampling from a listing of California registered nurses with current membership in the NANN was used to obtain the study's sampling frame.


PRINCIPAL RESULTS: Less than half of the nurses felt that newborn pain is well managed within the NICUs where they are employed. Barriers identified related to physicians' pain management practices, lack of evidence-based pain management protocols, nurses' and physicians' resistance to change practice, infant pain assessment tools, and inadequate staff training regarding pain assessment and management.


CONCLUSION: A knowledge-practice gap still exists within newborn pain management. Increased caregiver education remains a necessity, but strategies that address resistance to change practice within healthcare settings must also be considered.