FLACC in the measurement of post-operative pain in verbally impaired children

Abstract

This is a review addressing the question: How valid is the FLACC when compared to other measures in measuring post-operative pain in verbally-impaired children? During my placement within the paediatric clinical areas I noticed that locally the pain level in children who are verbally impaired is assessed by the most experienced nurses in the setting. This may not always be appropriate, because this limits best care only to when these nurses are available and this is also a subjective method, hence having the possibility of reducing accuracy. Therefore the FLACC pain assessment behavioural tool was chosen amongst other tools for its ease of use in the clinical setting. The population of interest in this study consisted of children aged 0-19 years, the intervention being tested was the FLACC tool, against other methods of pain assessment serving as the comparison. The intended outcome was the validity of the FLACC. The main inclusion and exclusion criteria applied included; the selected age range, a comparison of the FLACC to other methods of pain assessment and studies written in the English language. Studies were appraised using a slightly revised version of the diagnostic study Critical Appraisal Tools. The results showed that the FLACC tool is valid for assessing post-operative pain in verbally impaired children although revised versions of this tool where rendered to be more accurate in cognitively impaired children and critically ill children. The results were based on a limited amount of studies, and therefore recommendations for more and improved research were made. Finally it was concluded that locally it would be ideal to integrate the FLACC in the pain assessment strategy considering that no behavioural tool is being used at the moment.