{"id":1517,"date":"2016-02-18T16:50:26","date_gmt":"2016-02-18T16:50:26","guid":{"rendered":"https:\/\/lab.research.sickkids.ca\/stevens\/?page_id=1517"},"modified":"2018-03-09T21:04:05","modified_gmt":"2018-03-09T21:04:05","slug":"past-projects","status":"publish","type":"page","link":"https:\/\/lab.research.sickkids.ca\/stevens\/past-projects\/","title":{"rendered":"Past Projects"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 hundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-overflow:visible;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-column-no-min-height\" style=\"--awb-bg-size:cover;--awb-margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-1 sep-underline sep-solid fusion-title-text fusion-title-size-one\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Past Projects<\/h1><\/div><div class=\"fusion-text fusion-text-1\"><p>Bonnie Stevens\u2019 program of research focuses on generating new knowledge on pain assessment and management for hospitalized infants and developing knowledge translation (KT) strategies to improve pain outcomes in health care settings that care for infants and children.<\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first fusion-column-no-min-height\" style=\"--awb-bg-size:cover;width:48%; margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-two\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><strong>Knowledge Translation:<\/strong><\/h2><\/div><div class=\"fusion-text fusion-text-2\"><p><div class=\"fusion-modal modal fade modal-1 cihr\" tabindex=\"-1\" role=\"dialog\" aria-labelledby=\"modal-heading-1\" aria-hidden=\"true\" style=\"--awb-border-color:#ebebeb;--awb-background:#f6f6f6;\"><div class=\"modal-dialog modal-lg\" role=\"document\"><div class=\"modal-content fusion-modal-content\"><div class=\"modal-header\"><button class=\"close\" type=\"button\" data-dismiss=\"modal\" aria-hidden=\"true\" aria-label=\"Close\">&times;<\/button><h3 class=\"modal-title\" id=\"modal-heading-1\" data-dismiss=\"modal\" aria-hidden=\"true\">CIHR Team in Children's Pain<\/h3><\/div><div class=\"modal-body fusion-clearfix\"><strong>CIHR Team in Children&#8217;s Pain<\/strong><\/p>\n<p>The CIHR Team in Children\u2019s Pain was a multidisciplinary research team from nursing, medicine, psychology, and pharmacy with clinical and research expertise in pediatric pain, research utilization, evidence-based practice, quality assurance, and multiple research methods. The team conducted a novel, integrative, theoretically-based program. They carried out three studies:<\/p>\n<ul>\n<li><b><i>Study 1 <\/i><\/b>\u2013 Creation of the Pediatric Pain Research Network \u2013 Establishing Baseline Pediatric Pain Practices<\/li>\n<li><b><i>Study 2 <\/i><\/b>\u2013 Determining the Impact of Context on Pediatric Pain Process and Clinical Outcomes<\/li>\n<li><b><i>Study 3 <\/i><\/b>&#8211; Determining the effectiveness of the Evidence-Based Practice for Improving Quality (EPIQ) intervention in improving pediatric pain process and clinical outcomes<\/li>\n<\/ul>\n<p><\/div><div class=\"modal-footer\"><button class=\"fusion-button button-default button-medium button default medium\" type=\"button\" data-dismiss=\"modal\">Close<\/button><\/div><\/div><\/div><\/div>\n<div class=\"fusion-button-wrapper\"><a class=\"fusion-button button-3d button-xlarge button-default fusion-button-default button-1 fusion-button-default-span \" target=\"_self\" href=\"#\" data-toggle=\"modal\" data-target=\".fusion-modal.cihr\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">CIHR Team in Children&#8217;s Pain <\/span><\/a><\/div><\/p>\n<\/div><div class=\"fusion-text fusion-text-3\"><p><div class=\"fusion-modal modal fade modal-2 ghana\" tabindex=\"-1\" role=\"dialog\" aria-labelledby=\"modal-heading-2\" aria-hidden=\"true\" style=\"--awb-border-color:#ebebeb;--awb-background:#f6f6f6;\"><div class=\"modal-dialog modal-lg\" role=\"document\"><div class=\"modal-content fusion-modal-content\"><div class=\"modal-header\"><button class=\"close\" type=\"button\" data-dismiss=\"modal\" aria-hidden=\"true\" aria-label=\"Close\">&times;<\/button><h3 class=\"modal-title\" id=\"modal-heading-2\" data-dismiss=\"modal\" aria-hidden=\"true\">Toolkit for Minimizing Pain (Ghana)<\/h3><\/div><div class=\"modal-body fusion-clearfix\">The Toolkit for Minimizing Pain in Infants (funded by Saving Brains, Grand Challenges Canada), based on EPIQ, was developed in collaboration with local stakeholders in Ghana, to improve the management of acute procedural pain in neonatal intensive care units. This two-year project (2013-2015) included integrating the Toolkit in the curriculum of a school of nursing and pilot-testing it in a neonatal intensive care unit in Ghana. Analysis of implementation and effectiveness outcomes is underway.<\/p>\n<p>This toolkit includes two flip charts:<\/p>\n<p><a href=\"http:\/\/www.sickkids.ca\/pdfs\/Research\/stevens-research\/65927-Ghana_Flipchart.pdf\">Healthcare Professional Flip Charts<\/a> these flip charts help guide the process of pain practice change in neonatal intensive care units with evidence on age appropriate pain management and assessment practices and knowledge translation tools.<\/p>\n<p><a href=\"http:\/\/www.sickkids.ca\/pdfs\/Research\/stevens-research\/65926-Ghana%20Parent%20flipchart.pdf\">Parent Flip Charts<\/a> these flip charts provide guidance on how parents can be involved in managing their infant\u2019s pain.<\/p>\n<p><\/div><div class=\"modal-footer\"><button class=\"fusion-button button-default button-medium button default medium\" type=\"button\" data-dismiss=\"modal\">Close<\/button><\/div><\/div><\/div><\/div>\n<div class=\"fusion-button-wrapper\"><a class=\"fusion-button button-3d button-xlarge button-default fusion-button-default button-2 fusion-button-default-span \" target=\"_self\" href=\"#\" data-toggle=\"modal\" data-target=\".fusion-modal.ghana\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Toolkit for Minimizing Pain (Ghana) <\/span><\/a><\/div><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last fusion-column-no-min-height\" style=\"--awb-bg-size:cover;width:48%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-two\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><strong>Infant Pain:<\/strong><\/h2><\/div><div class=\"fusion-text fusion-text-4\"><p><div class=\"fusion-modal modal fade modal-3 pini\" tabindex=\"-1\" role=\"dialog\" aria-labelledby=\"modal-heading-3\" aria-hidden=\"true\" style=\"--awb-border-color:#ebebeb;--awb-background:#f6f6f6;\"><div class=\"modal-dialog modal-lg\" role=\"document\"><div class=\"modal-content fusion-modal-content\"><div class=\"modal-header\"><button class=\"close\" type=\"button\" data-dismiss=\"modal\" aria-hidden=\"true\" aria-label=\"Close\">&times;<\/button><h3 class=\"modal-title\" id=\"modal-heading-3\" data-dismiss=\"modal\" aria-hidden=\"true\">Pain in Infants at Risk for Neurological Impairment (PINI)<\/h3><\/div><div class=\"modal-body fusion-clearfix\"><strong>PINI Phase 1 and 2 (1998-2008)<\/strong><\/p>\n<p>PINI Phases 1 and 2 were the beginnings of a comprehensive research program on Pain in Infants at Risk for Neurological Impairment, with the goals of determining (1) the prevalence, frequency and nature of painful procedures in this population; (2) the most valid and reliable indicators for pain assessment; and (3) the most effective interventions for painful procedures in neonates at high, moderate and low risk for neurological impairment.<\/p>\n<p>Phase 1 of the study identified pain responses in neonates at high, moderate and low risk for neurological impairment (NI) and the most reliable and valid indicators for pain assessment. Results revealed that neonates at the highest risk for NI had more procedures and fewer interventions to manage pain in the first days of life. In addition, neonates at the highest risk for NI had responses to painful procedures that were the most diminished and difficult to interpret compared to more mature neonates. Phase 2 established the feasibility of selected interventions in more mature preterm neonates.<\/p>\n<p><strong>PINI Phase 3: Analysis in progress<\/strong><br \/>\nPhase 3 of the PINI study includes four studies focused on pain in Extremely Low Gestational Age (ELGA) neonates.<\/p>\n<ul>\n<li><strong>Study 1 and 2<\/strong><br \/>\nThe objective of studies 1 and 2 in Phase 3 of the PINI study were to explore the perceptions of health professionals and parents on pain in Extremely Low Gestational Age (ELGA) neonates. These perceptions influence the ways in which their pain is managed. Health-care professional\u2019s perceptions of pain influence their pain assessment and pain management strategies. Parent perceptions towards their child\u2019s pain provide a more in depth understanding of neonatal cues of pain. Analysis for these studies is ongoing.<\/li>\n<li><strong>Study 3<\/strong><br \/>\nThe objective of study 3 were to determine the pain responses of ELGA neonates, factors that affect these responses and how they change over time. Through a combination of physiological indicators, facial and body indicators and crying, we set out to determine how infant contextual variables influence pain responses in ELGA infants over time. By understanding how ELGA infants respond to pain, we can work towards better pain management strategies thereby improving their quality of life. Data analysis for this study is currently underway.<\/li>\n<li><strong>Study 4<\/strong><br \/>\nThe objective of study 4 was to determine the feasibility of non-pharmacological pain interventions in ELGA neonates. Pacifier, sucrose and facilitated tucking were used to manage procedural pain in ELGA neonates. Babies were be observed to see how well they tolerate each type of intervention and how they influence pain indicators. This research will establish if non-pharmacological pain interventions are feasible for ELGA neonates, and help us learn if combinations of comfort measures are safe and easy to use in order to manage pain in ELGA infants. Data analysis for this study is currently underway.<\/li>\n<\/ul>\n<p><strong>Publications:<\/strong><\/p>\n<ul>\n<li><strong>B. Stevens<\/strong>, S. Riahi, R. Cardoso, M. Ballantyne, J. Yamada + PINI Research Team. (2011). The influence of context on pain practices in the NICU: perceptions of health care professionals.. Qualitative Health Research, 21(6), 757-770.<\/li>\n<li>S. Gibbins, <strong>B. Stevens<\/strong>, K. Dionne, J. Yamada, R. Pillai Riddell, P. McGrath, E. Asztalos, B. Kyololo, J. Beyene, P. McNamara, C. Johnston. Perceptions of health professionals on pain in extremely low gestational age infants. Qualitative Health Research. 25(6), 763-774.<\/li>\n<\/ul>\n<p><\/div><div class=\"modal-footer\"><button class=\"fusion-button button-default button-medium button default medium\" type=\"button\" data-dismiss=\"modal\">Close<\/button><\/div><\/div><\/div><\/div>\n<div class=\"fusion-button-wrapper\"><a class=\"fusion-button button-3d button-xlarge button-default fusion-button-default button-3 fusion-button-default-span button-resize\" target=\"_self\" href=\"#\" data-toggle=\"modal\" data-target=\".fusion-modal.pini\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Pain in Infants at Risk for Neurological Impairment (PINI) <\/span><\/a><\/div><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":73,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1517","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.0) - 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