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Neonates' response to pain after venipuncture was studied by observing, recording, and measuring physiological and behavioral responses. The measurement used was the National Individualized Developmental Care Assessment Program (NIDCAP). Data were recorded from a convenience sample of 30 neonates required to have a venipuncture as part of their routine treatment for 20 minutes before and 20 minutes following the procedure by a person certified as reliable in administering the NIDCAP. Both behavioral and physiologic changes were observed. Most of the infants (93 percent) moved abruptly into a hyperalert or crying state in response to venipuncture, skipping several states without transition and showing disorganized behavior. The heart rate, oxygen saturation, and skin color showed significant changes when data recorded just prior to venipuncture were compared to data recorded immediately following the procedure. Nursing implications, including the unit environmental elements, are discussed.
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