WIP 84 - Analysis of the Impact of Social Determinants of Health on Comfort Measures Used During Needlesticks in Neonatal Intensive Care Unit (NICU)

Poster Number: WIP 84
Publication Number: WIP 84.870

Background: During a neonatal intensive care unit (NICU) hospitalization, infants experience many painful needlestick procedures. Neonates born preterm have difficulties modulating pain which can have lasting neurodevelopmental and sensational effects. Effective comfort interventions during these procedures may mitigate short-term experience of pain and improve long-term outcomes. While non-pharmacologic comfort measures for needlesticks have been described, standard of care varies widely. When there is a lack of standardized protocols, disparities in effective pain management strategies may be seen. Prior studies have shown racial disparities in pain management strategies in older children.

Objective: To analyze the correlations between SDOH and non-pharmacologic comfort strategies during needlesticks for neonates admitted to a Level III NICU at a safety-net hospital.

Design/Methods: This study is being conducted at UMass Memorial Medical Center’s (UMMMC) NICU and was approved by the institutional review board (IRB) of UMass Chan Medical School. This prospective study includes neonates admitted to the NICU from August 2023 to January 2024 who underwent a needlestick procedure.
Needlesticks are observed by staff who record needlestick type (venous, arterial, intramuscular injections) and non-pharmacological interventions (swaddle, facilitated tucking, skin-to-skin, breastfeeding, oral sucrose, non-nutritive sucking). SDOH is abstracted from the patients’ and mothers’ medical records including race, age, sex, insurance status, child opportunity index, parental education level, parental mental health, parental marital status, maternal substance use, and the involvement of the Department of Children and Families.
For each needlestick encounter, bivariate analyses will be performed to compare the types of non-pharmacological comfort measured used and existing SDOH of the patient and their family to correlate quality of care with social factors. We plan to complete data collection by January 31, 2024, and complete data analysis by March 15, 2024.