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Atraumatic care is the philosophy of providing therapeutic care through the use of interventions that eliminate or minimize the psychologic and physical distress experienced by children and families (Whaley & Wong, 1995). The foundation of this principle lies in minimizing separation of child from family, identifying child/family stressors, minimizing/preventing pain, and promoting parentprofessional partnerships. A review of pain management practices in one neonatal intensive care unit demonstrated underprescription and under-administration of pain medication as well as inconsistencies among practitioners. Written guidelines, developed by an interdisciplinary team and provided here, integrated current research in the assessment and management of procedural, postoperative, and other pain in infants. Use of the pain management guidelines, which serve as a foundation for the unit's commitment to atraumatic care, have improved pain management practices and have standardized care for infants on the unit.
Donna Wong defines atraumatic care as the provision of therapeutic care by health care personnel through the use of interventions that eliminate or minimize the psychologic and physical distress experienced by children and their families (Whaley & Wong, 1995). Therapeutic care involves the prevention, diagnosis, treatment, or palliation of chronic or acute conditions. In the neonatal intensive care unit, various stressors can cause distress for the infant and family. Psychological distress for parents may include anxiety, fear, anger, disappointment, sadness, failure, guilt, inadequacy, loss of control, helplessness, and hopelessness (Wiggins, 1994). Psychological stressors for parents can include concern for their infant, length of stay in the hospital, inability to communicate effectively with health care professionals, and inadequate knowledge and understanding of the disease or situation. Environmental stressors for the infants and families may include unfamiliar surroundings, unfamiliar sounds (monitors, alarms), crying, constant lights, activity related to other patients, and either a sense of urgency or a lack of urgency or concern from the staff (Whaley & Wong, 1995). Standardization of the approach to specific stressors is an important institutional strategy aimed at reducing the distress effect of those stressors.
Pain is one of the major physical stressors for the hospitalized infant and their parents. Published federal guidelines give practitioners some foundation on which to base practice related to assessing and managing pain in infants and children (Agency for Health Care Policy & Research [AHCPR], 1992). This article...