• Nicole L Bohr, Elizabeth Ely, Kirsten S Hanrahan, Ann Marie McCarthy, and Cynthia M LaFond.
• Department of Nursing Research and Evidence-Based Practice, University of Chicago Medicine, Chicago, Illinois; Section of Vascular Surgery and Endovascular Therapy, University of Chicago Biological Sciences Division, Chicago, Illinois. Electronic address: nicole.pierce@uchospitals.edu.
• Pain Manag Nurs. 2022 Jun 1; 23 (3): 267272267-272.

AimsThe majority of patients in the pediatric intensive care unit (PICU) experience pain daily, while nonpharmacologic interventions are indicated for pain management in children, there is limited information on which nonpharmacologic interventions are provided in the PICU and which patients receive those interventions. The aim of this descriptive correlational secondary data analysis was to determine what nonpharmacologic interventions were recorded in the electronic health record of PICU patients and patterns in use by patient demographics.Setting/SubjectsAll patients hospitalized in 15 participating PICUs are located within 12 unique children's hospitals across the United States were eligible for participation.MethodsNonpharmacologic interventions used in the PICU were identified and differences between patients who did and did not receive those interventions were examined using Fisher's exact test. A generalized linear mixed effects model was constructed to determine patient characteristics that predict nonpharmacologic pain intervention application.ResultsOf 220 enrolled patients, 97 (44%) had nonpharmacologic pain interventions recorded in their electronic health record. The most frequently recorded interventions included repositioning (65%), decreasing environmental stimuli (55%), caregiver presence (37%), distraction (23%), and music therapy (20%). Children who had moderate to severe pain were most likely to receive nonpharmacologic pain interventions.ConclusionsNonpharmacologic pain management is applied inconsistently across PICUs and may be underdocumented or underutilized. Additional research is needed to determine when nurses use nonpharmacologic pain interventions, their rationale for applying these interventions across differing groups, and the effectiveness of these interventions in managing pain in critically ill children.Copyright © 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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