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Integration of Certified Child Life Specialists to Decrease in Periprocedural Benzodiazepine Use: A Pilot Study
Anne Faulk1, Julia Power1, Hector Mejia2
1Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.
Insights
Certified Child Life Specialists (CCLSs) effectively reduce periprocedural anxiety in pediatric patients, significantly decreasing benzodiazepine use during medical procedures. This integration enhances patient comfort and safety, minimizing the need for sedatives.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Healthcare Management
Background:
- Periprocedural anxiety is prevalent in pediatric patients, exacerbated by events like anesthesia induction and IV placement.
- Factors such as parental anxiety and child sociability can influence pediatric anxiety levels.
- Certified Child Life Specialists (CCLSs) offer a non-pharmacological approach to mitigate patient and parental anxiety.
Purpose of the Study:
- To evaluate the impact of integrating Certified Child Life Specialists (CCLSs) into the perioperative setting.
- To assess the effect of CCLS intervention on benzodiazepine utilization in pediatric patients.
- To determine the safety and efficacy of CCLS support in reducing periprocedural anxiety.
Main Methods:
- A prospective database analysis identified pediatric patients undergoing outpatient surgical and radiologic procedures between July 2022 and September 2023.
- Certified Child Life Specialists (CCLSs) provided age-appropriate support to children to minimize benzodiazepine use.
- Data on benzodiazepine administration and adverse events were collected and analyzed.
Main Results:
- A total of 2175 pediatric patients received support from CCLSs.
- Midazolam use decreased by an average of 11.4% in the same-day surgery group.
- The radiologic group experienced a significant 73% reduction in benzodiazepine use, with no reported adverse events.
Conclusions:
- The integration of CCLSs in the periprocedural setting is a valuable strategy for managing pediatric anxiety.
- CCLS support effectively reduces the reliance on benzodiazepines for anxiety management in children.
- Utilizing CCLSs enhances patient safety by minimizing potential side effects associated with sedative medications.
Introduction:
Periprocedural anxiety is common in pediatric patients and is characterized by tension, anxiety, irritability, and autonomic activation. Periprocedural anxiety increases during certain events including admission to the preoperative area, separation from caregivers, induction of anesthesia, and IV placement. A study of children aged 2-12 showed that perioperative anxiety in children may be influenced by high parental anxiety and low sociability of the child. While these are nonmodifiable variables in the perioperative setting, there are numerous ways to ameliorate both parental and patient anxiety including the use of certified child life specialists (CCLSs) to aid in child comfort. In this study, our objective was to evaluate the integration of CCLS in our perioperative setting on the rate of benzodiazepine use.
Methods:
We used a prospectively maintained database to identify patients undergoing outpatient elective surgical and radiologic procedures from July 2022 to September 2023 and January 2023 to September 2023 respectively. CCLSs were used to work with appropriately aged children in order to decrease the use of benzodiazepines and reduce possible adverse events associated with their use.
Results:
A total of 2175 pediatric patients were seen by CCLS in same day surgery from July 2022 to September 2023. During this period, midazolam use decreased by an average of 11.4% (range 6.2%-19.3%). An even greater effect was seen in the radiologic group with 73% reduction. No adverse events were reported during this period.
Conclusions:
CCLSs working with age-appropriate patients in the periprocedural setting is a useful adjunct in easing anxiety in pediatric patients, reducing the need for periprocedural benzodiazepine administration and the risk of exposure to unintended side effects.
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