Systematic review and implementation of neonatal pain related clinical practice guidelines in the neonatal intensive care unit

Abstract

Two chapters, including a systematic review chapter and an empirical chapter, followed by a brief reflective appendix. A range of qualitative research methodologies were employed to investigate neonatal pain related clinical practice guidelines in the neonatal intensive care unit.

The systematic review provides a content analysis of the specific recommendations provided within existing clinical practice guidelines for the assessment and management of procedural pain in neonates. 20 clinical practice guidelines were included. The systematic review highlighted improvements are required in relation to the vagueness of recommendations and inconsistencies, given that clinical practice guidelines should facilitate the use of evidence in practice. However, translating evidence into practice is a complicated process that requires behavioural change amongst healthcare professionals. It would be important for future research to consider exploring and understanding these barriers further, especially with nursing staff as they are the individuals on the ground implementing recommended practice with neonates in the NICU, day to day. To establish from their perspective what the barriers are and how they believe they could be overcome to inform interventions to change behaviour and improve clinical practice.

The second chapter is an empirical study that study adopted the Theoretical Domains Framework (TDF) to explore nurses' knowledge and attitudes of clinical practice guidelines related to neonatal pain assessment and nonpharmacological pain management techniques. Semi-structured interviews were completed with nurses. Twelve of the theoretical domains were identified as relevant to the implementation of clinical practice guidelines. Using the TDF, allowed this study to identify factors that influenced the implementation of neonatal pain assessment and nonpharmacological pain management related clinical practice guidelines. In terms of clinical implications The findings can be used to design theory-drive interventions by targeting specific behaviour change techniques to change the clinical practice of nurses.

Thesis is embargoed until 31 July 2024.

Date of Award	Jul 2023
Original language	English
Awarding Institution	Queen's University Belfast
Supervisor	Pauline Adair (Supervisor) & David McCormack (Supervisor)