{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T20:41:14Z","timestamp":1769632874004,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,7,21]],"date-time":"2013-07-21T00:00:00Z","timestamp":1374364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aims to evaluate the impact of a nurse\u2010initiated analgesia pathway (<jats:styled-content style=\"fixed-case\">NIAP<\/jats:styled-content>) intervention for paediatric patients in the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook a pre\u2010 and post\u2010intervention trial in a large, tertiary referral, mixed <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>. The intervention comprised development and implementation of a comprehensive <jats:styled-content style=\"fixed-case\">NIA<\/jats:styled-content> Standing Order. In addition to paracetamol, which nurses could initiate pre\u2010intervention, they were authorised to administer ibuprofen, paracetamol\/codeine combinations and topical local anaesthetics prior to a doctor assessing the patient. All nurses were trained and credentialed prior to administering the <jats:styled-content style=\"fixed-case\">NIAP<\/jats:styled-content>. Patients aged 5\u201317 years with a triage pain score of \u22654 (<jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>ong\u2013<jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>aker or numerical rating scale) were eligible for enrolment. The primary outcome was time to analgesia. Secondary outcomes were the proportion of patients who received \u2018adequate analgesia\u2019 and parental satisfaction with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> pain management (measured 48\u2009h post\u2010discharge).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010one children were enrolled in both the pre\u2010 and post\u2010intervention periods. Patient sex and mean age, weight and triage pain score did not differ between the groups (<jats:italic>P<\/jats:italic> &gt; 0.05). At post\u2010intervention, significantly more patients received nurse\u2010initiated analgesia (3.0% <jats:italic>vs<\/jats:italic> 43.9%; <jats:italic>P<\/jats:italic> &lt; 0.001) and the median time to analgesia was significantly reduced (58\u2009min <jats:italic>vs<\/jats:italic> 23\u2009min; <jats:italic>P<\/jats:italic> &lt; 0.01). Also, significantly more patients received \u2018adequate analgesia\u2019 post\u2010intervention (41.2% <jats:italic>vs<\/jats:italic> 72.5%; <jats:italic>P<\/jats:italic> &lt; 0.001). At follow up, the proportion of parents who were very satisfied with their child's overall pain management trended upwards in the post\u2010intervention period (47.1% <jats:italic>vs<\/jats:italic> 66.7%; <jats:italic>P<\/jats:italic> = 0.07). No adverse events were observed during either period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">NIAP<\/jats:styled-content> significantly reduced time to analgesia. It was associated with high levels of parental satisfaction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.12103","type":"journal-article","created":{"date-parts":[[2013,7,22]],"date-time":"2013-07-22T00:23:08Z","timestamp":1374452588000},"page":"316-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Nurse\u2010initiated analgesia pathway for paediatric patients in the emergency department: A clinical intervention trial"],"prefix":"10.1111","volume":"25","author":[{"given":"Simone E","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Pharmacy Austin Health  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"McD Taylor","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Austin Health  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Jao","sequence":"additional","affiliation":[{"name":"Department of Medicine Austin Health  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyan","family":"Goh","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meagan","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Austin Health  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,7,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(89)90286-6"},{"key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/S0196-0644(05)82565-X","article-title":"Analgesic use in the emergency department","volume":"19","author":"Sebst SM","year":"1990","journal-title":"Ann. 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