Sant Joan de Déu Hospital
and Galenicum, a close
collaboration to protect
the most vulnerable patients -
Hospital without pain
One of the therapeutic objectives of the Sant Joan de Déu professionals is that no patient experiences pain during his stay in hospital nor when he returns home. This implies a set of prevention and treatment measures that are performed in the operating room, in the ER and ICU, and also in clinics and hospital wards.
Hospital without pain in minor procedures
The hospital now has an innovative pain control line that is incorporated into measures related to minor procedures, that is, procedures carried out when the patient is awake. In developing this program, Sant Joan de Déu Hospital has the support of Galenicum.
What is the hospital without pain in minor procedures?
The objective of the hospital without pain in minor procedures is to prevent and minimize the pain and discomfort that children experience when they’re subjected to painful procedures that, though they are uncomfortable, they do not require general anaesthesia. This may be a cure, a probe or withdrawing a catheter. These are initiatives that go beyond pharmacological treatment and act on emotions such as fear and anxiety that augment the perception of pain. It’s estimated that each year all patients will benefit from this program.
Implementing this program requires the implication, sensitisation and training of professionals and families alike. To roll out the program to the entire hospital, a network of professionals works in a transversal way which allows for understanding the patients’ needs and to work on the initiatives that are proposed.
The hospital without pain in minor procedures initiative is focused on three objectives:
1. That the professionals systematically apply all the resources available to them to evaluate whether the patients are suffering pain and to treat it in the most appropriate way.
2. That they have at the top of their minds that any procedure can involve pain, that it does not occur only in just the more complicated interventions.
3. That they inform children, explaining what is involved in the procedures in a language appropriate for and adapted to the child’s age.
What strategies are available to the professionals?
The program includes a wide array of pharmacological and non- pharmacological methods adapted for each child.
The strategies that the professionals of the Sant Joan de Déu Hospital utilize to minimise hospitalised children’s pain are based on four main lines of action:
1. The administration of analgesics such as foams, syrups, drops...
2. The effective use of distraction as a powerful tool to combat fear and pain.
3. Positive reinforcement.
4. The presence of parents.
The professionals have at their disposable an ample variety of strategies that they apply during healthcare procedures. Galenicum contributes to making this a reality as the exclusive financier of the project, assuming part of the cost of the materials utilized and the required analgesics, and driving communication actions that combine to turn into a genuine cultural change.
What have we done so far?
For the treatment of pain
The no pain kit. There are many procedures that cause pain which are carried out while the child is awake, such as puncture or wound care. The “kit” contains a set of pharmaceutics and devices aimed at making it so that children don’t experience pain. Some elements of the “kit” to highlight are:
- Sacarosa, which reduces the pain new-borns and breast-feeding babies feel when the heel is pricked.
- Local anaesthetic creams that make the skin go to sleep therefore temporarily making the skin in that area desensitized to the procedure, such as a puncture.
- 50% nitrous oxide, a homogenous gas with a mixture of 50% oxygen and 50% nitrous oxide that provides pain relief as well as reducing anxiety during painful minor procedures.
- Buzzy, a device shaped like a bee that uses cold and vibration to the nerves that are closest to the intervention area and helps reduce pain.
- Tools/methods to make fear go away, drugs to reduce the anxiety related to a procedure.
Distraction kit. Angst and fear can increase children’s perception of pain during painful procedures. Distraction, directing their attention away from pain and focusing it on a something pleasant, helps prevent the experience being negative and makes the procedure more successful. Everything is useful: talking with the child, singing, cuddling… the hospital professionals have a case that contains small toys for children of all ages so that the child gets involved in playing with what he likes best while the professional removes a catheter or carries out any other invasive procedure. One distraction element that has very good results is soap bubbles: via this toy, the child does respiratory exercises without realizing it, which help him relax and focus his attention away from the painful procedure.
Pain scale: A plastic card that shows a scale of 0 to 10 with drawings of faces that represent different pain states helps the professional “measure” the pain that the child is experiencing.
Courage detector: This tourniquet with a wide band and a child-friendly look was created especially for children. It’s intended to make the most stressful moment into a game aimed at distracting the child while he’s given an injection.
To spread knowledge
The active role of the family
The hospital is dedicated to the idea that the entire family be actively implicated in any potentially-painful procedure, that they are present during the procedures and that they participate in the distraction techniques.
When a procedure is being carried out that could potentially be painful, the health professionals encourage parents to hold their children comfortably in specific ways that facilitate the procedure and combat anxiety in the child, his family and the professionals. In surgeries, important changes are being made that will soon allow for improved information and increasing the number of parents who can stay with their children until they go to sleep before an intervention.
The importance of positive reinforcement
Positively reinforcing of the child’s behaviour is fundamental to making the procedures more agile and reaching the objectives of reducing pain and anxiety during procedures. In this way, throughout the care process, verbal reinforcement of the child's actions is carried out, cheering him on and encouraging him.
In Sant Joan de Déu Hospital, professionals value that the children make an effort that when they collaborate in a treatment, rewarding them with various prizes: such as the certificate of courage or the Courage medal. This initiative has been well received by patients and families, and makes children feel like authentic heroes.
Sant Joan de Déu Hospital is one of the principal hospitals of reference within and outside of Catalonia for paediatrics, obstetrics and gynaecology, and in highly-specialised areas such as neuroscience, neonatology, oncology and heart surgery. The centre, which belongs to the Hospitaller Order of San Juan de Dios, attends to over 120,000 emergencies, 25,000 in-patients and 200,000 visits each year, combining the latest in technology with personalized care based on the values of hospitality and solidarity.
For more information, visit www.hsjdbcn.org
Galenicum is a pharmaceutical Company dedicated to the development of pharmaceutical products, mainly generics. Our activities include the development, registration and commercialisation of medicines, and the sale of active ingredients. With a global vision, the headquarters is in Barcelona, and we have offices in Madrid, Brazil, Peru, Chile, Malta, China and India. Galenicum’s missions is to improve people’s health and quality of life, doing everything without our power so that the patient can overcome his disease.
We know that offering the ideal drug is crucial, but so is providing impeccable health care and emotional support to the patient, as the patient's positive feelings play a fundamental role in the healing process and in his quality of life.
Sant Joan de Déu Hospital brings together all these elements in the Hospital without pain project, providing the most vulnerable hospital patients a more positive experience. To Galenicum, as individuals and as a company, it is a pleasure to participate.
Believe in kids. Believe in life.