Abstract
1. Introduction
Health professionals conducting medical procedures with children, face challenges in avoiding a physical struggle, minimising pain, and preventing distress for both child and parent. These challenges are particularly evident in Burns Units. Studies suggest that ~50% of children with burn injuries display some post-traumatic symptoms [1]. Younger children are also particularly susceptible to high distress and anticipatory fear, which may contribute further to pain. Several studies indicate that distraction techniques can reduce children’s pain and distress during these wound care procedures [2,3].
2. Short description of practice change implemented
Starlight is a non-profit organisation, committed to supporting integrated care through the hospital and community programs it delivers to improve the lives of seriously ill children and young people.
Identifying the impact of painful procedures, Starlight piloted the ‘Captains on Call’ initiative in the Day Surgery Burns Unit of Adelaide’s Women’s and Children’s Hospital. It involves Starlight Captains (highly skilled professional performers) using fun, play and distraction techniques to reduce child and parent stress and anxiety, working with the medical team to meet the unique needs of each patient.
3. Aim and theory of change
Ultimately, the aim of ‘Captains on Call’ is to reduce the distress and pain experienced, through integrating Captain Starlight with the clinical team. This reduces anticipatory fear for follow-up visits, improves the attitudes towards health professionals, and creates a positive, anxiety-free hospital experience. For the Burns Unit specifically, this may ultimately help reduce the currently high prevalence of post-traumatic symptoms occurring.
4. Targeted population and stakeholders
The target population for this initiative is children requiring medical procedures. Key stakeholders include family members, Health professionals, the broader hospital community and Starlight.
5. Timeline
The pilot commenced in 2018, with evaluation findings available by October 2019.
6. Highlights (innovation, Impact and outcomes)
‘Captains on Call’ is the first documented initiative in Australia providing positive distraction to paediatric patients undergoing potentially distressing and painful medical procedures. This care integration has the potential to improve psychosocial outcomes, reduce pain and minimise the potentially traumatic nature of the procedure.
7. Comments on sustainability
Embedded within every children’s hospital, Starlight is a well-established organisation,
in the advantageous position to extend ‘Captains on Call’ nationally. There is no cost incurred to the health system and appears to be minimal burden on clinic staff.
8. Comments on transferability
The model is applicable to other medical procedures for children. Starlight are currently in discussions to expand this initiative to other clinics, such as Fractures and Oncology.
9. Conclusions
Early data indicates the program impacts positively, creating a notable difference to children’s experience. Parents and clinicians report a reduction in anxiety and improved overall medical experience. All children and parents want ‘Captains on Call’ available for return visits.
10. Discussions
Program evaluation data will be discussed, highlighting successes and challenges.
11. Lessons learned
Starlight reviewed the pilot process of integrating the initiative within paediatric units, leading to specific training and outlining parameters to ensure successful implementation.