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Featured Course: A Multidisciplinary Approach to Implement Non-Pharmacological Strategies to Manage Pain and Stress for Neonates

“It was astounding to hear how many painful/stressful procedures occur, many for which the infant’s pain isn’t addressed. It was also amazing to think about what kind of impact we therapists can make by assisting during these procedures and educating our teammates. ” – Kay West, OTR/L, CNT

Speaker: Emily Hills, OT, MSc

Course Description: Newborns, both term and preterm, endure many painful procedures following a Neonatal Intensive Care Unit (NICU) admission (Carbajal et al. 2008). Unmanaged neonatal pain impacts on short-term and long-term neurodevelopmental outcomes (Granau 2013) and parental well-being (Franck et al. 2012). Neonatal pain management guidelines identify the use of non-pharmacological strategies to reduce pain (American Academy of Pediatrics, 2006). Cochrane reviews promote the use of breastfeeding, skin-to-skin contact and sucrose to minimize pain (Stevens et al. 2016) (Riddell et al. 2015)(Johnson et al. 2014)(Shah et al. 2012).

Yet while clinicians are aware of the efficacy of nonpharmacological strategies, it has been shown that they do not always implement them into neonatal care (American Academy of Pediatrics 2006). It is ethically irresponsible to allow another human being to suffer, this is especially so when there is good quality evidence available to manage neonatal pain, which is both easy and cost effective. The canon ‘to do no harm’ is without doubt the primary responsibility and objective of every member of the neonatal team. This presentation describes a multidisciplinary, quality improvement project using a Plan-Do-Study-Act (PDSA) cycle to implement nonpharmacological strategies. In order to determine the most effective ways to do this, a systematic review of the literature was carried out, specifically to answer the question: “What interventions and approaches are effective in the implementation of non-pharmacological strategies to manage pain and stress for neonates?’

Using thematic analysis, five main themes of non-pharmacological implementation strategies emerged: Parental participation, improved communication, continual education, availability of resources and organizational involvement. This course will summarize the results from questionnaires and service evaluation and the steps used to integrate these five themes of non-pharmacological implementation. Finally, the clinicians’ reflections on applicability of the PDSA cycle as a quality improvement tool will also be included.

Target Audience: OT, SLP, PT, RN, and Neonatal professionals

Level: Intermediate

CE Credit: PT, OT, SLP – 1 hour

Fee: $57 or FREE for NANT Members


  1. Critically review current literature on the implementation of non-pharmacological strategies to manage pain and stress for the neonate.
  2. Describe a recent quality improvement project, using a PDSA cycle to change practice and implement non-pharmacological strategies.
  3. Summarize and reflect on the interventions used to effectively implement non-pharmacological strategies to manage pain and stress.

Instructional Method: Recorded webinar with lecture and handouts. Learning assessment and course evaluation follow course.

“Emily did an excellent job explaining how she implemented her quality improvement project, including the failures/successes. I also enjoyed learning about the different types of non-pharmacological strategies to manage pain and cannot wait to implement them in our NICU. “- Ashley Heppermann MOT, OTR/L, NTMTC

Take the course here.