Operationalizing Donna Wong's principle of atraumatic care: pain management protocol in the NICU.

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 parent-professional 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.