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Evaluation of a Nurse Practitioner Led Procedural Support Service for Children With Procedural Anxiety: An Effectiveness–Implementation Study

ABSTRACT

Aim

To evaluate the clinical effectiveness of a Nurse Practitioner led procedural support service for children with procedural anxiety, and identify facilitators and barriers to its sustained implementation and optimisation.

Design

An effectiveness–implementation hybrid type 3 study used a prospective mixed methods evaluation approach.

Methods

From December 2022 to May 2023, data were collected from children, parents and clinicians using a nurse practitioner-led service at a quaternary paediatric hospital in Brisbane, Australia. A prospective audit assessed clinical outcomes, while qualitative interviews explored implementation barriers and facilitators.

Findings

The clinical audit (n = 40) confirmed the service was effective and safe, ensuring procedural completion with minimal distress. Descriptive statistics indicated low pain and anxiety scores. There was a moderate negative relationship between pain scores and the use of distraction techniques. Interviews with thirty-three participants showed the service improved access to procedural care, reduced the need for physical restraint and general anaesthesia, and enhanced clinical workflow through preadmission assessments.

Conclusion

Utilising a Nurse Practitioner support service represents a safe and effective strategy to enhance access for paediatric patients with procedural anxiety.

Implications for the Profession and Patient Care

This study underscores the significance of specialised nursing roles in managing paediatric procedural anxiety, offering a replicable model to enhance procedural outcomes and mitigate medical trauma across healthcare settings.

Impact

Minimising pain and distress is important in all clinical encounters with children to reduce the risk of medical-related trauma and the future avoidance of healthcare.

Reporting Method

The report of study outcomes was guided by the Standards for Reporting Implementation Studies (StaRI) initiative.

Patient or Public Contribution

Patients or the public were not included in the design, conduct or reporting of the study.

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