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The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse’s assessment of neonates

Journal of Perinatology volume 35, pages 128–131 (2015)Cite this article

Subjects

Abstract

Objective:

To determine the reliability of an objective measure of pain, agitation and sedation using the Neonatal Pain, Agitation and Sedation Scale (N-PASS) compared with nursing bedside assessment.

Study Design:

Neonates admitted in neonatal intensive care unit over a 6-month period were eligible. Pain and sedation were assessed with N-PASS, and a subjective questionnaire was administered to the bedside nurse.

Result:

A total of 218 neonates were eligible (median: gestational age 34.6 weeks, age at assessment 7 days). N-PASS pain score correlated significantly with both nurses’ pain score (Spearman coefficient (r)=0.37; P<0.001) and agitation score (r=0.56; P<0.001). N-PASS sedation score correlated with nurses’ sedation score (r=−0.39; P<0.001). Adjusting for gestational age, day of life, intrauterine drug exposure and use of high frequency ventilation only slightly attenuated the correlations (r=0.36, 0.55 and −0.31, respectively).

Conclusion:

The N-PASS captures nursing assessment of pain, agitation and sedation in this broad population and provides a quantitative assessment of subjective descriptions that often drives patient therapy.

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Acknowledgements

We thank the NICU staff nurses at Johns Hopkins Hospital for their cooperation in this research. We also thank Christoph Lehmann, MD, for informatics support and Lauren Jansson, MD, and W Christopher Golden, MD, for their support as members of the B. Hillman’s scholarship oversight committee. Kathryn A Carson’s work on this publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number UL1 TR 000424-06 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS or NIH. None of the authors have financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Charlotte Bloomberg Children's Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    B A Hillman, M N Tabrizi, E B Gauda & S W Aucott

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    K A Carson

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  1. B A Hillman
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  2. M N Tabrizi
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  3. E B Gauda
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Correspondence to S W Aucott.

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Hillman, B., Tabrizi, M., Gauda, E. et al. The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse’s assessment of neonates. J Perinatol 35, 128–131 (2015). https://doi.org/10.1038/jp.2014.154

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