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Collecting peripheral blood samples via heelstick is used for several blood tests on neonates. Because of state requirements for metabolic screening, each baby will have at least one such test done prior to hospital discharge.

Literature demonstrates the basis for administration of sucrose, swaddling infant and/or the use of a pacifier to alleviate discomfort in the newborn during painful procedures. In 2007, nurses in a large urban tertiary OB unit were inconsistent in assessing, intervening and evaluating effectiveness of interventions for newborns undergoing a painful procedure.  In addition, nurses did not always use appropriate technique when performing a heelstick.

A pre and post test regarding the use and documentation of sucrose during painful procedures was administered. Nurses and ancillary personnel were educated in the appropriate heelstick technique and in the pre-procedure use of sucrose.  The aims of this education were: Improve efficiency in obtaining neonatal blood samples via heelstick; Decrease neonatal pain scores; Improve documentation of post-intervention pain scores; Increase patient comfort. Care-givers were observed to determine use of sucrose. These observations were repeated at a six month interval with a goal of 95% compliance.

Baseline sucrose use rate was 57%. Following education and testing, rate increased to 77%. During the subsequent six months, the rate reached 94%. The project was presented during the 2008 Nurses' Week Poster Session. Nurses from the ED and the In-patient Pediatric unit contacted the Mother/Baby nurses to help educate their staff in technique and use of sucrose.  During the subsequent 6 months, the OB unit nurses lapsed in their use of sucrose.  The project was re-implemented in June, 2009. Because of hospital restructuring, inpatient and outpatient OB and Pediatrics were integrated and are now under the Department of Women & Children's Health. In August, 2009, Pediatric Clinic nurses initiated sucrose use. Data will continue to be assessed until the AWHONN Convention and presented at that time.

This project has heightened awareness of pain management needs of the neonate. Use of sucrose is a simple, safe, effective and non-pharmaceutical way to relieve pain for the newborn during painful procedures.