Document Type

DNP - Open Access

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Dannica Callies

Second Advisor

Brandon Varilek

Library of Congress Subject Headings

Background/Purpose: Pain in infancy due to immunization administration often goes untreated. The pain infants experience leads to negative effects on neurodevelopment and pain response. Needle fear develops in infancy and can extend into adulthood, leading to vaccine avoidance and endemic outbreaks.
Methods: In a family practice clinic in an upper Midwest state, an oral sucrose protocol was implemented for use by advanced practice providers (APPs). Prior to education on the protocol, a survey was administered to assess the providers’ knowledge, attitudes, and practice (KAP) in relation to oral sucrose. The providers were educated on the benefits and intended use of oral sucrose prior to the oral sucrose protocol being implemented throughout the clinic. After 8 weeks, the survey was repeated, and the two KAP surveys were compared and analyzed statistically.
Results: A statistically significant improvement was found in the knowledge, attitudes, and practices of clinic APPs.
Discussion: Due to statistical significance upon analysis, this quality improvement project has the potential to become sustainable practice. It is difficult to make this a regular practice in a rural area due to patient population. Recommendations would be to implement in a large family practice or pediatric clinic to confirm sustainability.
Implications for Practice: Oral sucrose has a quick onset and is cost-effective. Implementing an oral sucrose protocol can block pain response in infants receiving immunizations, which may promote adherence to vaccine schedules, improve the health of the population, and decrease healthcare costs related to preventable illness.


South Dakota State University


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