Saturday, 16 November 2013
Sherry Stott, MSN, BSN
Women and Infant Services, Banner Thunderbird Medical Center, Glendale, AZ
Learning Objective 1: The learner will be able identify one validated method to measure pain responses during newborn blood collection using a heel stick or venipuncture.
Learning Objective 2: The learner will be able to describe two leadership methods needed to conduct a nursing research project.
Critical mandatory genetic screening for metabolic disorders of all newborns requires nurses to obtain blood samples either by heel lance (HL) or venipuncture (VP). It is within the nurses’ scope of practice to determine which procedure to use to obtain the sample. While previous studies provide evidence that VP is less painful, studies were conducted using an expert phlebotomist. It is not known if these results can be obtained in the clinical setting where multiple nurses obtain the blood samples as part of routine clinical care. The purpose of this study is to determine whether there is a difference in pain response between HL and VP procedures used by nurses for metabolic blood sampling in newborns. The study uses an experimental design with 154 newborns randomly assigned to one of two parallel groups: HL or VP. Newborns are assessed for pain response before, during and after the blood sampling procedure. Facial response during the sampling procedure is video-recorded by a member of the research team. Two additional members of the research team, blind to the method used to obtain the blood sample, independently review the recorded videos to score the newborn’s pain response using the Neonatal Facial Coding System (NFCS). Repeated measures ANOVA will be used to determine whether there is a difference between mean NFCS scores between HL and VP procedures at the three time points.
This transformational leadership journey meets my goal to lead a unit of staff nurses through a nursing research project from protocol development, identifying and resolving barriers, determining inclusion-exclusion criteria, writing standardized procedures, developing workflow algorithms, and training nurses in research data collection. Outcomes will guide decisions about metabolic screening specimen collection procedures throughout Banner Health and may influence decisions about blood sampling for this population statewide.
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