Multisite cross-sectional survey of nurses’ perceptions of implementation of a parent-targeted video and recommended pain management, for improving newborn pain treatment

Background Synthesized evidence of analgesic effects of breastfeeding, skin-to-skin care, and sucrose for newborns undergoing painful procedures exists; however, these interventions are inconsistently used in practice. Although a parent-targeted video demonstrating these interventions is publicly accessible, its implementation has not been rigorously evaluated. Purpose To evaluate clinical nurses' and nurse unit managers’ perceptions of the video implementation which portrays three pain-reducing interventions, and barriers and facilitators to implementing the video and interventions in practice. Methods This study was part of a larger multisite s study in eight maternal-newborn centres in Ontario, Canada. This current study used online cross-sectional surveys with open and closed-ended questions administered following a 6-month intervention period where the parent-targeted video was made available for staff to share with parents before blood sampling for newborn screening. Two surveys were used: one for clinical nurses and one for nurse unit managers from participating maternal/newborn units. Participants provided their perceptions of the video's implementation and barriers and facilitators of using the pain management strategies. Descriptive statistics were used for quantitative data, and reflexive content analysis was applied to qualitative data. Results Thirty of 205 (15 %) eligible nurses and nine unit managers from the eight participating sites completed the surveys. Eighteen (60 %) nurses and five managers (55 %) perceived the video was offered to less than half of the parents, highlighting the video was not implemented into their units as planned. Key barriers reported by both groups were being too busy to show the video with parents in the post-natal period and a preference for not involving parents in pain treatments. Facilitators included working towards Baby Friendly Hospital Initiatives endorsement and single-room units. Implications Increasing parents' involvement during painful procedures is widely recommended. However, as the parent-targeted video alone was not implemented as planned, and staff preferences and unit cultures do not consistently facilitate parents' involvement, further work is needed to improve parents’ advocacy and role in the care of their newborns.