Utilization of Pain Rating Scales in Pediatric Care among Health Professionals at Gertrude’s Children’s Hospital

Abstract

Pain is the most common stimuli experienced by pediatric patients. It is mainly managed based on the intensity which is determined through utilization of pain rating scales. Utilization of pain measurement tools in pediatric care is vital because they indicate the level and intensity of pain in the patients. The purpose of the study was to assess utilization of pain rating scales at Gertrude’s children’s hospital as a basis for making recommendation for their adoption by the Ministry of Health, Kenya. The study employed descriptive cross-sectional study design utilizing both quantitative and qualitative approaches. It was conducted at Gertrude’s children’s hospital in Nairobi-Kenya. The study population comprised health professionals working at the hospital and patients’ medical records. Data were collected using semi- structured self-administered questionnaire, key informant interview guide (KII) and observation check list from a sample size of 160 Health Professionals, five key informants and 71 patients’ medical records. Quantitative data was analyzed using descriptive statistics whereby data was summarized using frequency tables and presented using pie chart, and bar graphs. Content analysis was performed on qualitative data using inductive approach.The study revealed that the hospital has adopted four pain rating scales which included Neonatal Guide Score, FLACC, Wong Baker faces scale, and Numerical pain scale. These tools were utilized by the Health Professionals at the hospital with nurses being the main Health Professionals who utilized them. Health system factors which included staff training, protocols on pain management and frequent auditing supported their utilization. Being newly employed and use of FLACC in cognitively challenged patients were the main challenges in utilization of pain rating scales at the hospital. Nurses were the main Health Professionals who utilized pain rating scales at the hospital.Staff training, protocols on pain management and frequent auditing improved their utilization. Inclusion of pain assessment in the curriculum for all institutions training health professionals may address the challenge posed by the newly employed health professionals in utilization of pain rating scales. Further research on validity of FLACC in mentally challenged patients may be necessary in this setting.