"Let's Cope Together": An Evidence-based Approach to Caring for Patients Living With Autism in the Perioperative...

To determine if an individualized coping plan for pediatric patients with autism, available in the electronic health record, could improve their safety and comfort, and family satisfaction in the perioperative setting.

Evidence-based practice project.

The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care was used as a framework for the development and implementation of a program to create individualized perioperative coping plans in the electronic health record for pediatric patients living with autism. Evidence reviews of the literature informed the process, which included environmental and care modifications to achieve an optimal patient experience. Collaboration among nurses, physicians, and child life specialists was integral to project implementation.

During the implementation period of the pilot project, perioperative coping plans were documented for 60% of surgical patients living with autism. Incorporating the creation of the coping plan within the usual nursing preoperative phone call increased the coping plan documentation rate to 90%. Tools and visual reminders built into the electronic health record facilitated the sustainment of the program. The surgical services team was able to make accommodations to perioperative processes and environment when team members had awareness of the child's individual needs.

Creation of a perioperative coping plan was a feasible intervention when incorporated into the preoperative phone call. In addition to the coping plan, environmental modifications engaged the health care team to provide individualized care and work toward the goal of an optimal perioperative experience for all.