Improving paediatric pain management in the emergency department: An integrative literature review.

摘要: Background : Children presenting to the emergency department continue experience suboptimal pain management. While evidence - based management interventions are available clinicians, effective and sustainable practice change is yet be achieved. This gap requires a collaborative approach knowl edge translation targeting systems of care. Objectives The purpose this review was explore level in for improved paediatric Design Integrative review. Data sources CINAHL, Embase, PubMed/Me dline, Dynamed, Cochrane, Scopus, Prospero Joanna Briggs Institute were systematically searched, clinical guidelines reference lists scanned. Review methods Studies screened selected according inclusion criteria, independ ently appraised risk bias. methodology informed data extraction synthesis, focused on organisational context engagement, facilitation implementation change, key components interventio ns, evaluation. Results Twenty studies met criteria: 18 uncontrolled pretest-posttest two pseudo-randomised design. Study populations ranged from children with specific presentation, all children. All adopted multifaceted bundling various including assessment tools protocols, clinician education, nurse-initiated analgesia, feedback family engagement. Four used local analysis inform applied an framework. Time analgesia most commonly primary outcome. Parent child sensitive outcomes assessed five studies. Interventions that hold promise optimised if embedded workplace include involvement at each stage department. Conclusion way forward respectfully engage stakeholders—children, parents clinicians—to collaboratively develop evidence-based, solutions aligned context. Guided by framework, future research designed creatively translate into facilitate priority. Key solution integration management, considering outcome measures. Effectiveness new should evaluated short long term embed change. Frontline nurses well placed lead transformation