Virtual reality: feasibility of implementation in a regional burn center

Burn care providers continue to search for non-pharmacologic adjuncts for pain control. Virtual reality (VR) has been shown to be a useful adjunct by reducing pain during burn care and therapy. The feasibility of implementation for clinical use (non-research related) has not been studied in a burn center. The purpose of this study was to determine staff resources needed to implement VR in a regional burn center.

Ten patients with burns participated in VR during occupational or physical therapy sessions. A portable computer and VR head mounted device (Proview VO35, Kaiser Electro-Optics, Inc.) and the "SnowWorld" software (Patterson and Hoffman, University of Washington) were used. Two staff members trained in the use of VR participated in each session in order to adhere to infection control policies. VR set-up time, patient instruction time, VR therapy time, and equipment cleaning time were recorded and rounded to the nearest minute.

A mean of 59 staff time minutes (S.D. 18; range 29-85) were required for set-up, instruction, VR therapy, and cleaning. Set-up required the most time, averaging 23min. Instruction, participation, and clean-up means were 6, 13, and 16min respectively. Time for set-up decreased over time, however technical difficulties with the VR equipment accounted for most of the variability in the time required.

These results suggest VR requires a significant time commitment from staff for implementation. One clear disadvantage was the lack of on-site technical support for equipment troubleshooting. In the current healthcare environment where therapists and nurses are accounting for each minute, it would be difficult for smaller burn centers to allocate staff and resources to implement a VR program. Further research is needed to determine if VR benefits are worth the implementation costs.