| Objectives: Based on evidence-based method,qualitative interview combined with expert meeting method,a scientific,reasonable and practical evaluation and management plan for needle-related pain in neonate with NICU was constructed,with a view to reducing pain caused by needle-related operations,improving clinical outcomes and improving the quality of pain management in neonate with NICU.To provide reference for NICU clinical staff to develop localized neonatal pain management programs.Methods: 1.Based on evidence In this study,evidence-based questions were constructed according to the PICOS principle in the problem development tool of evidence-based Nursing Center of Fudan University.Based on the "6S" evidence pyramid model,relevant evidence on the evaluation and management of needle-related pain in neonate with NICU was searched in the database.The search period was from January 1,2010 to April 1,2022.Four researchers independently evaluated literature quality and extracted evidence.2.Qualitative interview Objective sampling method was adopted to conduct group interviews with NICU clinical front-line staff from 4 third-class A hospitals in Jinan,Shandong Province from June to July 2022,and finally 12 NICU clinical front-line staff were included as interview subjects to investigate the views of NICU clinical front-line staff on the assessment and management of needle-related pain in NICU neonate.Record the interview process,arrange the interview notes of the day within 24 h after the end of the interview,transcribe and encode the recording within 72 h,read the recording repeatedly,classify the content of the recording,and then use the seven-step analysis method of Colaizzi phenomenon data to analyze the data and extract the theme.3.Expert meeting method On November 12,2022,an online expert meeting was held with the help of Tencent conference software.Experts with high academic authority and practical experience in various departments worked together to give full play to brainstorming,demonstrate and make final judgment on the evaluation and management plan from different perspectives,and construct the final version of the evaluation and management plan for NICU neonate’s needling pain.Results: 1.A total of 1465 literatures were obtained through preliminary search,and 15 literatures were finally included after reviewing,reading abstracts,and excluding literatures that did not meet the inclusion criteria: There were 3 randomized controlled trials,6 systematic reviews,2 guidelines,2 expert consensus,and 2 clinical decisions.A total of 38 pieces of evidence were extracted from the included literatures,which were finally summarized into 27 pieces of best evidence in 6 dimensions,including pain assessment timing,pain assessment tools,pain assessment methods,operation management,non-drug management,and drug management.2.Five major themes were extracted from the qualitative interview: uneven cognitive level and compliance of needle-related pain assessment and management in NICU neonate;The use of scale and pain management focus is not uniform;The neonate themselves have obvious differences;Medical drugs and nursing equipment are lacking and not scientifically managed;The environment is bad.According to the theme,four suggestions were put forward: strengthening the evaluation and management training of needle-related pain in neonate with NICU;Unified use of scale and appropriate adjustment of doctors’ focus;Adequate supply and proper storage of medical drugs and nursing appliances;Create a good department atmosphere.3.On December 11,2022,the research group invited a total of 10 directors from the national nursing Department,director/head nurse of neonatal department,attending physician/head nurse of neonatology department,professors proficient in neonatal treatment and nursing,and experts proficient in evidence-based nursing.The average authority coefficient of the experts of the expert meeting was Cr=0.94.Sort out 18 expert suggestions or opinions and revise them one by one.Conclusion: 1.This study summarizes the best evidence for the evaluation and management of needle-related pain in neonate with NICU,involving 6 aspects,and provides certain evidence-based evidence for the evaluation and management of needle-related pain in neonate with NICU.2.According to the five topics,four suggestions were put forward,and the best evidence was combined to summarize and initially establish the evaluation and management plan of needle-related pain in neonate with NICU.3.Formulate and improve the evaluation and management plan according to the expert opinions,and finally construct the evaluation and management plan of needle-related pain of NICU neonate with scientific basis and in line with the clinical practice.The description of each evaluation and management situation is specific,which meets the nursing needs of NICU neonate with needle-related pain.It can provide scientific and reasonable practice basis for clinical staff of NICU. |
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