• Patricia J Byrd, Irene Gonzales, and Virgil Parsons.
• Intensive Care Nursery, Kaiser Permanente Hayward Medical Center, Hayward, California 94545, USA. LadybyrdRN@comcast.net
• Adv Neonatal Care. 2009 Dec 1;9(6):299-306.

PurposeTo explore barriers that NICU nurses face when attempting to optimally manage newborn pain.SubjectsNinety California NICU nurses with current membership in the National Association of Neonatal Nurses (NANN) voluntarily participated.DesignA descriptive survey study.MethodsA researcher-developed survey consisting of 37 questions was mailed to 300 NICU nurses; 102 were returned and 90 were usable. Probability sampling from a listing of California registered nurses with current membership in the NANN was used to obtain the study's sampling frame.Principal ResultsLess than half of the nurses felt that newborn pain is well managed within the NICUs where they are employed. Barriers identified related to physicians' pain management practices, lack of evidence-based pain management protocols, nurses' and physicians' resistance to change practice, infant pain assessment tools, and inadequate staff training regarding pain assessment and management.ConclusionA knowledge-practice gap still exists within newborn pain management. Increased caregiver education remains a necessity, but strategies that address resistance to change practice within healthcare settings must also be considered.

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