Eleven participants reported being aware of the scales, which facilitate the evaluation of pain in the newborn, and mentioned the Neonatal Infant Pain Scale
(Nips) as an example of an instrument for this purpose.
* Neonatal Infant Pain Scale
(NIPS) - used for the assessment of procedural pain in premature newborns, and full-term newborns;
Neonatal Infant Pain Scale (NIPS) is used for the pain assessment in neonates.
Table 5: CHIPPS for the postoperative pain assessment Item Structure Points * None 0 Crying * Moaning 1 * Screaming 2 * Relaxed/smiling 0 Facial expression * Wry mouth 1 * Grimace (mouth and eyes) 2 * Neutral 0 Posture of the trunk * Variable 1 * Rear up 2 * Neutral, released 0 Posture of the legs * Kicking about 1 * Tightened 2 * None 0 Motor restlessness * Moderate 1 * Restless 2 Table 6: Neonatal Infant Pain Scale Variable Finding Points Facial * Relaxed (restful face, neutral 0 expression expression) * Grimace (tight facial muscles, 1 furrowed brow, chin, jaw) Cry * No cry (quiet, not crying) 0 * Whimper (mild moaning, 1 intermittent) * Vigorous crying (loud scream, 2 shrill, continuous.
Neonatal infant pain scale
(NIPS) was developed by Lawrence et al.
(7) Another study reported an increase of 33% in reported pain after using the Neonatal Infant Pain Scale tool.
(26,27,30) This supports Gallo's (21) study, which found a 33 percent increase in reports of pain assessment after using the Neonatal Infant Pain Scale tool in the ICU chart.
These included the Neonatal Facial Activity Coding System (4), the Neonatal Infant Pain Scale
(2,3), crying (1,4,5), grimacing (1), and physiological parameters such as heart rate (1,2,4,5), respiratory rate (2,3), blood pressure and oxygen saturation (5,6).
The effectiveness of pain control was assessed by measuring the baseline heart rate (HR), respiratory rate (RR) and Neonatal infant Pain Scale
(NIPS scale) before the start of procedure and measuring of these parameters for each step of circumcision.
Assess for pain/effectiveness of pain relief measures using the Neonatal Infant Pain Scale
(NIPS) (see Table 3), on the following schedule: a.
Measurements of blood pressure, heart rate, respiratory rate, and oxygen saturation were obtained along with a Neonatal Infant Pain Scale
(NIPS) grading at five separate intervals (baseline, restraint, incision, Gomco[R] clamp application, and post circumcision) throughout the circumcision procedure.
Many research studies and review articles have focused on the development of assessment tools and rating scales, including the Oucher (Beyer & Aradine, 1986), the Poker Chip Tool (Hester, 1979), the Children's Hospital of Eastern Ontario Pain Scale (McGrath et al., 1985), the Neonatal Infant Pain Scale
(Lawrence et al., 1993), and the Wong-Baker FACES Pain Rating Scale (WBFPRS) (Wong, 1995).