Pediatric Postoperative Pain Management in Surgical Wards - an Intervention Study

This study will be conducted on four surgical wards in one university hospital in Norway. There will be used different methodological approaches for data collections (interviews, questionnaire, observational study) with four measurement points; baseline (T1), and one month (T2), six months (T3) and 12 months (T4) after intervention.

To get a broader view of barriers and facilitators for effective pediatric postoperative pain management, there will be carried out focus group interviews with healthcare providers. Further, data about healthcare providers' knowledge and attitudes regarding pediatric pain will be collected using a questionnaire. Data about nurses' pediatric postoperative pain management will be collected using non-participant observational study and data about children's experience about pain and pain management will be collected using face-to-face interviews with children. This study will have different phases:

Phase 1 Explore healthcare providers' knowledge, clinical practice children's experiences of pain and pain management, and healthcare providers' experiences of barriers and facilitators for effective pain management

• Questionnaire PNKAS-N
• Observation of clinical practice
• Face-to-face interviews with children
• Focus group interviews with healthcare providers (barriers and facilitators)

Phase 2 Develop and implement a tailored educational intervention

Develop tailored educational intervention based on:

• Available research
• Results from baseline
• Feedback from head of the relevant units
• Staff views about the facilitators and barriers to optimized pediatric pain management

Implementation of the intervention

• Seminar (lecture and workshop)
• Clinical supervision
• Reminders

Phase 3 Evaluation of the intervention

• Questionnaire PNKAS-N
• Observation of clinical practice

Questionnaire

Inclusion criteria

• nurses working at all four wards and all surgeons (experienced) at the corresponding wards

Exclusion criteria

• nurses not involved in clinical work

Observational study

Inclusion criteria

• nurses working in all four wards
• children (0-18 years) admitted to these wards during the data collection period, and their parents

Interview with children

Inclusion criteria

• children (6-18 years) going through surgery at all four wards during the data collection period, and their parents

Exclusion criteria

• children with cognitive impairment who were unable to communicate verbally
• children who did not speak Norwegian
• children younger than six years

Interview with healthcare providers

Inclusion criteria

• healthcare providers working in the four wards (two to four nurses, two surgeons, and two anesthesiologists in each group)