Systematic ReviewResearchWorkflow

Child life services reduced pediatric procedural pain, but study differences temper the pooled effect

Journal of pain research (PubMed)Jul 15, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A three-level meta-analysis of 12 studies involving 1,366 children found that child life services were associated with less procedural pain than standard care, although high between-study heterogeneity limits confidence in how large or broadly transferable the effect is.

What NurseJet pulled from the source

This registered systematic review and three-level meta-analysis evaluated child life services for children undergoing medical procedures. Twelve randomized or quasi-experimental studies with 1,366 participants were included. Child life services were associated with lower procedural pain than standard care, with a pooled Hedges' g of -0.72, but 85% between-study heterogeneity indicated substantial variation. Subgroup findings suggested larger effects among children age 7 or younger, one-time injections, and post-procedure assessments; assessor type was the only statistically significant moderator. Sensitivity analyses supported the overall finding, but evidence for older children and surgical settings remains less clear.

Why this matters for nurses

Pediatric nurses coordinate pharmacologic pain treatment with preparation, coping support, caregiver involvement, and developmentally appropriate comfort measures. This review supports integrating trained child life professionals where available while continuing structured pain assessment.

Bedside takeaway

Child life support can complement ordered analgesia for pediatric procedures, but nurses should assess each child's response because effects varied substantially.

How This Applies in Practice

Use this when: Planning a potentially painful or distressing procedure for a child when trained child life support is available.

On your shift

Refer early enough for the child life specialist to assess developmental needs and prepare an individualized coping plan.
Coordinate the coping plan with caregiver involvement, comfort positioning, and the ordered pharmacologic analgesia strategy.
Record pain and distress before and after the procedure and communicate when the child's response requires a different approach.

Keep in mind: Child life services complement rather than replace analgesia or clinical monitoring. Follow the pediatric pain protocol, facility policy, and patient-specific provider orders.

Key takeaways

The review included 12 studies and 1,366 pediatric participants.
Child life services were associated with a moderate pooled reduction in procedural pain compared with standard care.
Between-study heterogeneity was high, so the average effect may not predict results for every age, procedure, or program.
Evidence appeared strongest for younger children and one-time injections, while older-child and surgical evidence needs further study.

Practice implications

Identify procedures likely to cause distress early enough to involve child life staff, then coordinate age-appropriate preparation and coping support with the ordered analgesia plan. Document pain before and after the procedure and adjust the support plan when the child's response differs from expectations.

Limitations & cautions

Only 12 studies were pooled, and between-study heterogeneity was high. Programs, procedures, age groups, outcome timing, and pain assessors differed, and the abstract includes randomized and quasi-experimental evidence. Subgroup findings may be unstable, and evidence was less clear for older children and surgical contexts.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Journal of pain research (PubMed)

Journal of pain research (PubMed). The Effectiveness of Child Life Services in Reducing Pediatric Procedural Pain: A Systematic Review and Three-Level Meta-Analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42473616/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A retrospective analysis of US natality data found no statistically significant yearly difference in neonatal mortality between freestanding birth centers and hospitals among term, singleton, vertex births without major medical risk factors from 2015 through 2024.

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Adjusted neonatal-mortality odds for freestanding birth centers fluctuated around 1.0 across the 10-year study period. No individual year showed a statistically significant difference from hospital births, including 2020 and 2021 when birth-center volume increased.

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The analysis was restricted to births meeting selected low-risk criteria.
The study found no evidence that higher birth-center use during the pandemic years increased neonatal mortality.
The observational design cannot establish that birth setting itself caused the mortality pattern.

Why this matters on shift

The findings add national outcome data for counseling and systems planning around freestanding birth-center care for appropriately selected low-risk pregnancies.

Bedside takeaway

Apply local eligibility, surveillance, escalation, and transfer protocols when caring for planned low-risk birth-center patients.

Nursing implications

Keep eligibility, surveillance, escalation, and transfer decisions anchored to local birth-center criteria and maternal-newborn protocols.

Limitations & cautions

Abstract-only summary. The study used retrospective vital-record data, was limited to selected low-risk births, and cannot exclude residual differences between people who delivered in birth centers and hospitals.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of midwifery & women's health (PubMed). Neonatal Mortality Risk Among Births in Freestanding Birth Centers, 2015 to 2024.

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AI-summarized from the linked source. Review the original article before applying to practice.

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A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

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The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

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The median participant age was 14 months, and 67% of participants were male.
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The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

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Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

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Journal of neurology (PubMed)Sep 6, 2026Systematic Review

A cumulative meta-analysis found longer survival over time in Duchenne muscular dystrophy, alongside a shift from predominantly respiratory toward cardiac causes of death.

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The review included 53 studies and more than 13,000 patients. Pooled median survival was 29 years among ventilated patients and 19 years among non-ventilated patients, but these study-level observational comparisons do not establish that ventilation alone caused the difference.

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Why this matters on shift

Patients living longer with Duchenne muscular dystrophy may need sustained respiratory support plus ongoing cardiac and multisystem surveillance across care transitions.

Bedside takeaway

Verify each patient's established respiratory and cardiac plan during admissions and care transitions.

Nursing implications

During admissions and handoffs, verify the established ventilation, airway-clearance, and cardiac-monitoring plan and coordinate concerns with the multidisciplinary team.

Limitations & cautions

Abstract-only summary. This was a study-level meta-analysis of heterogeneous observational survival reports; the ventilated and non-ventilated groups were not randomized, so associations should not be interpreted as treatment effects.
AI-summarized from the linked source. Review the original article before applying to practice.

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Journal of neurology (PubMed). Improving survival in Duchenne muscular dystrophy across eras: a systematic review and cumulative meta-analysis.

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How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

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