An international study on innovations in the management of children’s pain

Background: Children have a right to effective pain management and up to date guidelines are available to promote this. Despite this, many reports state that children’s pain in hospital settings is not managed well, and many children are left to suffer unnecessarily. Nearly a quarter of children surveyed said they were in pain all or most of the time they were in hospital (Picker, 2005). However, this is not the whole picture; many areas deliver effective and innovative pain management for children. Aim: The aim of this travel scholarship was to undertake a study to identify innovations and learn from examples of good practice in the management of children’s pain by visiting three areas of excellence in the UK, Sweden and Australia. Methods: The study took an Appreciative Inquiry approach, focusing on learning from good practice, and follows four stages: • Discovery (the best of what is): this involved visits to the three study areas and meeting practitioners, educators and researchers to explore innovations in their pain management practice • Dream (what might be): this involved meeting with the host at the end of each study week to present to them identified examples of good practice for confirmation • Design (what should be): this involved writing up the findings of the three visits, exploring what innovations could be introduced to improve pain management practice across the UK • Destiny: this is dissemination and implementation of the best practice examples identified Conclusions: In each area visited, confident practitioners identified innovations in their pain management practice that have improved children’s pain experience in hospital. Innovations ranged from environmental adjustments to reduce anxiety related to pain, to standardising children’s observation charts to promote the regular assessment of pain. Effective leadership was apparent at each study site. Implications for practice: • Appreciative Inquiry is about identifying what works so that it can be repeated • Confidence and self-belief underpin the practice of effective pain management teams • An effective leader with a vision is needed to drive continuous improvement in the management of children’s pai