Evaluation of a Nurse Practitioner Led Procedural Support Service for Children With Procedural Anxiety: An...

Area of Science:

• Pediatric Healthcare
• Nursing Practice
• Implementation Science

Background:

• Procedural anxiety is a significant challenge in pediatric healthcare, potentially leading to distress and avoidance.
• Specialized nursing services can play a crucial role in managing anxiety and improving patient outcomes.

Purpose of the Study:

• To evaluate the clinical effectiveness of a Nurse Practitioner-led procedural support service for children experiencing procedural anxiety.
• To identify facilitators and barriers for the sustained implementation and optimization of such a service.

Main Methods:

• An effectiveness-implementation hybrid type 3 study utilized a prospective mixed methods approach.
• Data collection involved a prospective audit of clinical outcomes (n=40) and qualitative interviews with children, parents, and clinicians (n=33).
• The study was conducted at a quaternary pediatric hospital in Brisbane, Australia, from December 2022 to May 2023.

Main Results:

• The Nurse Practitioner-led service was effective and safe, ensuring procedural completion with minimal distress and low pain/anxiety scores.
• The service improved access to procedural care, reduced the need for physical restraint and general anesthesia, and enhanced clinical workflow.
• A moderate negative relationship was observed between pain scores and the use of distraction techniques.

Conclusions:

• Nurse Practitioner-led procedural support services are a safe and effective strategy for enhancing care access for pediatric patients with procedural anxiety.
• Specialized nursing roles are significant in managing pediatric procedural anxiety, offering a replicable model to improve outcomes and mitigate medical trauma.