Title : From evidence to action: A fellowship-led standardized pain management protocol for pediatric needle insertion
Abstract:
Pediatric procedural pain particularly during needle insertions remains one of the most undertreated and distressing aspects of care for children and their families. Despite decades of research supporting the use of topical anesthetics and nonpharmacologic strategies, wide variations in practice continue to compromise comfort, trust, and equitable care delivery. This session presents a nurse-led initiative that reimagines pain management through standardization, interprofessional collaboration, and a culture of accountability. The project emerged from an evidence-based practice fellowship at a 496-bed Magnetdesignated children’s hospital, where frontline nurses identified inconsistencies in managing procedural pain. Recognizing that practice variation contributes to patient and family distress, a team of RN Fellows partnered with pharmacy, providers, and unit leaders to implement a standardized pain management protocol for needle procedures on an inpatient pediatric unit. Grounded in the Iowa Model of Evidence-Based Practice and guided by Plan-Do-Study-Act cycles, the protocol aimed to improve consistency, reduce unnecessary suffering, and build provider confidence. Implementation included staff education, quick-reference tools, pharmacy process improvements, and provider engagement strategies to ensure reliable access and order compliance. The session will share outcomes of the initiative, which improved topical anesthetic use from 21% to 76% in just three months. Beyond the data, the session will focus on the mindset and workflow shift how standardization empowered nurses to advocate for pediatric pain relief, facilitated interprofessional alignment, and reinforced the message that even small interventions can make a significant difference in patient experience. Attendees will explore institutional and cultural barriers to pediatric pain management and how frontline nurses can lead systemic improvements through evidence and collaboration. The discussion will highlight how embedding protocols into clinical routines fosters sustainability, reduces disparities, and supports nurse engagement. By the end of the session, attendees will take away practical strategies for implementing evidence-based change, engaging stakeholders, and measuring both clinical and experiential impact. This session positions pain management as a reflection of institutional values, a benchmark of health equity, and a prime opportunity for nursing leadership. In reimagining pediatric procedural pain management, we also reimagine the nurse's role as innovator, advocate, and bridge between evidence and empathy. Through standardization, education, and collaboration, nurses can redefine compassionate care and ensure every child receives it.
