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Paediatr Child Health. 2013 Aug;18(7):367-72.

Implementation of a new clinical practice guideline regarding pain management during childhood vaccine injections.

Author information

British Columbia Centre for Disease Control, Vancouver, British Columbia;
Division of Pharmacy Practice, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario ; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario.


in English, French


To determine the impact of a multifaceted knowledge translation strategy for a new vaccination pain management guideline on public health immunizers' attitudes, beliefs and use of pain-relieving strategies during childhood vaccination.


Using a randomized controlled pre-post study design, public health nurses (PHNs) at intervention sites received a multifaceted knowledge translation intervention about new pain management guidelines incorporated in the British Columbia Immunization Program Manual, including education, supplies and online support. Attitudes and beliefs of PHNs toward immunization pain and pain management, and use of pain-relieving strategies were compared for the intervention sites between the pre- and postimplementation phases.


A total of 516 children were immunized by 31 PHNs pre- and postimplementation in the intervention sites. Postimplementation, satisfaction and confidence with ability to manage pain and willingness to use newly recommended strategies were significantly more positive (P<0.05) in the intervention sites, and overall use of at least one newly recommended strategy increased from 49.8% preintervention to 77.6% postimplementation (P<0.001).


The knowledge translation intervention improved PHN immunizers' attitudes, beliefs and practices regarding paediatric vaccination pain management. Reducing pain may result in a better immunization experience for children, caregivers and immunizers.


Clinical practice guideline; Immunization; Knowledge translation; Pain management; Public health nursing


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