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Implementation of the Baxter Animated Retching Faces Nausea Assessment Scale in Pediatric Oncology: A Quality
Carina Braeutigam1, Jennifer Young2, Jessica Shaw1
1From the Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatric Quality & Safety
|July 29, 2026
Summary
Implementing the Baxter Animated Retching Faces (BARF) scale significantly improved pediatric oncology nurses
Area of Science:
- Pediatric Oncology
- Quality Improvement
- Patient Symptom Management
Background:
- Chemotherapy-induced nausea presents unique challenges in pediatric oncology.
- Accurate nausea assessment is crucial for evaluating antiemetic efficacy and optimizing patient care.
Purpose of the Study:
- To introduce a pediatric nausea assessment tool.
- To standardize the process for improved nursing documentation of nausea.
Main Methods:
- A quality improvement project introduced the Baxter Animated Retching Faces (BARF) scale.
- Staff education and electronic medical record integration were key components.
- Plan-do-study-act methodology guided the process.
Main Results:
- Documentation of nausea assessments increased from 5% at baseline to 75% within one month.
- Rates peaked at 94% and remained above 75% for two years.
- The BARF scale was successfully integrated into routine care.
Conclusions:
- The BARF scale facilitated better documentation of nausea in pediatric oncology.
- Improved documentation bridged the gap between bedside assessment and treatment decisions.
- This enhanced patient care within the pediatric oncology service.
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