Assessing Neonatal Pain with NIPS and COMFORT-B: Evaluation of NICU’s Staff Competences

Table 1

Scoring and interpretation for the NIPS [16].

Facial expression	0	Relaxed
	1	Grimace
Cry	0	No cry
	1	Whimper (mild moaning or intermittent)
	2	Vigorous crying or silent cry (based on facial movements if intubated)
Breathing pattern	0	Relaxed
	1	Change in breathing (irregular, increased, gagging, breath holding)
Arms	0	Relaxed
	1	Flexed/extended (tense straight arms, rigid and/or rapid extension)
Legs	0	Relaxed
	1	Flexed/extended (tense straight legs, rigid and/or rapid extension)
State of arousal	0	Sleeping/awake (quiet, peaceful, settled)
	1	Fussy (alert, restless, and thrashing)
NIPS score interpretation		0–1: no pain; 2: mild pain; 3–4: moderate pain; 5–7: severe pain