Barriers and facilitators to using procedural pain treatments in pediatric patients (under 1 year old): protocol for a mixed studies systematic review with a narrative synthesis

Abstract

Background: The management of procedural pain in pediatric patients under 1 year old is crucial but often inadequately addressed in clinical practice. Despite proven evidence-based interventions like skin-to-skin contact, sweet solutions, and breastfeeding, their implementation remains sporadic. This systematic review aims to uncover the barriers and facilitators to adopting these interventions, leveraging the Consolidated Framework for Implementation Research (CFIR) to provide a structured analysis. Methods: This review will examine primary studies identifying barriers or facilitators to the use of procedural pain treatments in pediatric patients under 1 year old, imposing no restrictions on the publication year or language. A thorough search will cover databases such as MEDLINE (Ovid), Embase, CINAHL, PsycINFO, Web of Science, and Scopus. The Mixed Methods Appraisal Tool (MMAT) will be utilized for quality assessment. The CFIR framework will serve to categorize and analyze the identified barriers and facilitators, using narrative synthesis for data integration. Discussion: Applying the CFIR framework allows for a comprehensive and systematic review of the factors influencing the implementation of procedural pain management strategies in pediatric care. By identifying key barriers and facilitators through this lens, the review will guide the development of targeted interventions aimed at enhancing the adoption of evidence-based pain treatments. Such strategic interventions are essential for bridging the gap between research findings and clinical practice, potentially improving the effectiveness and efficiency of pain management for pediatric patients. Systematic review registration: PROSPERO CRD42022322319.