Supportive Interventions to Reduce Pain and Stress During Ophthalmic Examinations for Retinopathy of Prematurity in Premature Infants

BACKGROUND Ophthalmic examinations are a frequent source of pain and stress in premature infants. There is evidence for the use of supportive interventions during infant ophthalmic examinations to reduce pain and stress, but there are no standard recommendations for their implementation. PURPOSE The purpose of this quality improvement project was to implement evidence-based, supportive interventions during ophthalmic examinations in premature infants and evaluate the impact on pain, oxygen saturation, heart rate, bradycardic events, and neonatal stress cues. METHODS A preintervention and intervention group design was used. Primary outcomes were pain and oxygen saturation. Secondary outcomes were heart rate, number of bradycardic events, and number of neonatal stress cues. Independent-sample t tests were used to compare means of the measures in the preintervention and intervention groups. RESULTS Supportive interventions during ophthalmic examinations significantly reduced infant pain (during and after the examination), number of bradycardic events (during and after the examination), and number of neonatal stress cues (before, during, and after the examination). There was also a trend for supportive interventions to decrease pain before the examination. IMPLICATIONS FOR PRACTICE Supportive interventions during ophthalmic examinations are effective in reducing pain, bradycardic events, and neonatal stress cues in premature infants and can be successfully implemented as part of a unit-based protocol. IMPLICATIONS FOR RESEARCH Future research is needed to determine the long-term outcomes associated with supportive interventions during ophthalmic examinations in premature infants.