Impact of a Dynamic Visualized Pain Assessment Tool on Pediatric Pain Management: A Stepped-Wedge Cluster Randomized Trial.

Abstract

Effective pediatric pain management relies on accurate assessment; however, current behavioral scales are limited by observer subjectivity and fail to capture dynamic fluctuations. The primary goal of this protocol is to detail the implementation and evaluation of a dynamic visualized pain assessment tool, providing a standardized methodology to transition nursing practice from experience-based estimation to data-driven precision. Using a stepped-wedge cluster randomized trial design across five clinical wards, the study enrolled 15 infants and analyzed 45 video segments across three clinical contexts: baseline, acute procedural pain, and postoperative recovery. The system captured high-definition facial video synchronized with bedside physiological monitoring to generate real-time pain trajectory curves and trend-based alerts. Generalized linear mixed models showed that the tool reduced nursing response latency from 15.4 to 6.7 min (P < 0.001) and increased assessment consistency (intraclass correlation coefficient [ICC]: 0.71-0.93). Concurrently, pediatric satisfaction scores rose, and parental anxiety levels decreased. These findings suggest that dynamic visualization may improve clinical efficiency and patient outcomes through timely, objective decision support.