PEDIATRIC NURSES USE OF BEHAVIORS TO MAKE MEDICATION ADMINISTRATION DECISIONS IN INFANTS RECOVERING FROM SURGERY

Although behavioral observation is recommended as the primary pain ass essment for the nonverbal postsurgical child, little is known about cl inicians' use of observation in their medication administration decisi ons. Eight infants were videotaped after surgery and segments of the v ideotapes were categorized as medication inactive or medication active (assumed to relieve pain) based on the usual duration of infants' ana lgesics. Nurses (N = 50) viewed these segments, and mean percent agree ment with the pharmacologic categorization was 54%. Agreement was high for medication active segments and low for medication inactive ones. Nurses reported using the pain behaviors described in the literature a s well as other infant characteristics in their decision making. Infan t behaviors observed in the medication inactive snippets were not sugg estive enough of the presence of pain to result in the nurses choosing to medicate. (C) 1998 John Wiley & Sons, Inc.