Neil L. Schechter, MDa, Bruce A. Bernstein, PhDb,c, William T. Zempsky, MDc,d, Nancy S. Bright, BS, RNd, Alice K. Willard, BS, RNe
a Department of Anesthesia, Perioperative and Pain Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts;
d Division of Pain Medicine and
e Clinical Trials Unit, Connecticut Children’s Medical Center, Hartford, Connecticut;
c University of Connecticut School of Medicine, Farmington, Connecticut; and
b Department of Pediatrics, St Francis Hospital and Medical Center, Hartford, Connecticut
OBJECTIVE The goal was to examine the impact of a teaching module on immunization pain reduction practices in pediatric offices 1 and 6 months after the intervention.
METHODS Fourteen practices were selected randomly to receive a 1-hour teaching session on immunization pain reduction techniques, and 13 completed the study. Before the intervention, telephone interviews were conducted with parents concerning their children’s recent immunization experiences. At 1 and 6 months after the intervention, parents of children who had recent immunizations were interviewed by using the same questionnaires. Clinicians also were surveyed at baseline and at 6 months.
RESULTS A total of 839 telephone interviews and 92 clinician surveys were included. Significant changes from baseline were identified at 1 and 6 months after the intervention. At 1 month, parents were more likely to report receiving information (P = .04), using strategies to reduce pain (P < .01), learning something new (P < .01), using a ShotBlocker (P < .01), using sucrose (P < .01), and having higher levels of satisfaction (P = .015). At 6 months, all rates remained significantly higher than baseline findings (all P < .01) except for satisfaction. Clinician surveys revealed significant increases in the use of longer needles, sucrose, pinwheels, focused breathing, and ShotBlockers at 6 months.
CONCLUSIONS A 1-hour teaching session had measurable effects on the use of pain-reducing strategies at 1 and 6 months after the intervention. This research supports the hypothesis that small-group teaching sessions at the site of care can be associated with changes in practice behaviors.