Innovative models of care to improve utilisation of nitrous oxide for procedural pain management within a Paediatric Oncology short stay unit | ACCYPN

Innovative models of care to improve utilisation of nitrous oxide for procedural pain management within a Paediatric Oncology short stay unit

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Presenters: Mr John Watt1, Ms Jane Tinsley1,2, Professor Val Wilson1,2

1Sydney Children’s Hospitals Network , Randwick, Australia, 2University of Technology Sydney, Sydney, Australia

Date of presentation: 28th October 2016

Abstract

Aim

The use of Nitrous Oxide (N2O) for procedural pain management in our paediatric Oncology/Haematology short stay unit is underutilised. Our project aimed to gain an understanding of current practice and management of children having painful procedures, to identify the barriers to the utilisation of N2O and to develop, implement and evaluate an innovative model of care to improve pain management and advance nursing practice.

 Method

Patients, families and nursing staff were asked to complete an online questionnaire to identify barriers and to develop an understanding of the utilisation of N2O. In addition, retrospective audits of procedural lists for Oncology/Haematology outpatients were undertaken. Project stakeholders critically reviewed collected data in order to develop strategies and a model of care.

Result

Key findings from the online survey include:

  • patients rated pain associated with insertion of an intravenous cannula and venepuncture as high
  • many families (45%, n=15) did not know N2O was available
  • some nursing staff were unaware of the indications for the use of N2O

Audit findings identified that a nurse N2O administering model of care for procedural lists had no negative impact on patient flow and freed up Anaesthetic services enabling them to provide consultation in other areas. Overall staff was satisfied with the implementation of the model.

Conclusion

Innovative models of nursing care were effectively implemented and enabled the advancement of nursing practice. Future N2O training programs and strategies to improve families and staff’s knowledge are underway to further increase the utilisation of N2O for patients having painful procedures.

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