Authors (including presenting author) :
Lam D(1), Lam KSG(2), Yam SDF(3), Leung KYK(2), Chan KL (2), Tung YLJ (2), Law HF (2), Ho NPF(4), Kwok V (5)
Affiliation :
(1) Department of Anaesthesiology and Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong
(2) Department of Paediatric and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong
(3) Department of Paediatric Surgery, Hong Kong Children’s Hospital, Hong Kong
(4) Department of Operating Theatre/Surgery, Hong Kong Children’s Hospital, Hong Kong
(5) Department of Anaesthesiology and Perioperative Medicine, Hong Kong Children’s Hospital, Hong Kong
Keyword 3: :
Pain Assessment
Keyword 4: :
Pain Management
Keyword 5: :
Quality Improvement
Introduction :
Pain is commonly experienced by the paediatric patient population. Recognition and appropriate management of acute pain in paediatric patients is important, as poor management may lead to development of chronic pain, negatively impacting the child’s psychosocial well-being.
Objectives :
This study aimed to benchmark pain prevalence, causes, and effectiveness of pain management methods in the paediatric inpatient population in Hong Kong, thereby offering vital insights to reflect upon current practices and identify any gaps in management, guiding future improvements.
Methodology :
This prospective cross-sectional study was done on a single, unannounced working weekday at Hong Kong Children's Hospital. In-patients were recruited from all paediatric wards except neonatal intensive care unit. Respondents reported their pain experiences and its management in the last 24 hours. Patient medical records and analgesic medication records were also reviewed.
Result & Outcome :
139 children and parents or caretakers were located and completed the survey. 55% experienced pain in the last 24 hours during their current admission. Among all patients recruited, 18% experienced mild pain, and 37% rating their pain as moderate to severe. Needle procedures were the most common cause (37%) of worst pain in the last 24 hours, followed by surgeries (20%) and other invasive procedures (14%). Pain scores between different causes of pain showed no significant differences, implying needle pain is as distressing as other conditions and should be addressed. Pain assessments were only documented in 28% of inpatients. Discrepancy in pain scores was noted with patients' reported scores significantly higher than pain scores rated by medical staff. The most frequent pain management strategies were caretaker participation (47%) but only 5% of patients/parents reported having received information on pain management. This study uncovers a high yet underrecognized prevalence of paediatric pain in Hong Kong, highlighting under-managed needle-related distress as a key concern. To improve care standards, we propose enhancing clinical practice through regular and appropriate pain assessments, documentation, and improving dedicated staff training on paediatric essential pain management. Collaboration with HA Pain Management Service Committee with adaptation of existing Essential Pain Management (EPM) workshop by introducing paediatric pain assessment and management, EPM-Paed programme, is under way. Concurrently, launching hospital-wide evidence-based bundled strategies for needle and procedural pain is vital. Together, these actions will foster a culture of pain awareness, making every child's comfort a clear priority and ensuring sustained improvements in outcomes.
