scholarly journals Use of Audiobooks as an Environmental Distractor to Decrease State Anxiety in Children Waiting in the Pediatric Emergency Department: A Pilot and Feasibility Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Leah I. Stein Duker ◽  
Anita R. Schmidt ◽  
Phung K. Pham ◽  
Sofronia M. Ringold ◽  
Alan L. Nager
Keyword(s):  
Emergency Department ◽  
State Anxiety ◽  
Low Cost ◽  
Pediatric Emergency ◽  
Control Group ◽  
Pediatric Emergency Department ◽  
Post Intervention ◽  
Paired Samples ◽  
Before And After ◽  
The Impact

Objectives: Anxiety and anticipatory stressors are commonly experienced by children visiting the Pediatric Emergency Department (PED), but little research exists that addresses the efficacy of interventions to decrease this stress. This one-sample pretest-postest pilot study gathered preliminary data on the feasibility and effectiveness of utilizing audiobooks to reduce fear and state anxiety in children in the PED.Methods: Participants were 131 children in kindergarten through 8th grade (M = 9.4 years, 54% female), triaged urgent or emergent, presenting to the PED. Participants self-reported fear (Children's Fear Scale) and state anxiety (modified State-Trait Anxiety Inventory for Children; mSTAIC) before and after listening to an age-appropriate audiobook (two options). Data regarding patient experience were also collected. Paired samples t-test was used to examine pre–post intervention changes in fear and state anxiety.Results: Significant, albeit small, improvements in fear and the mSTAIC states of nervous, calm, happy, and relaxed were found after use of the audiobook (Cohen's dz = 0.22–0.35). Small, yet significant correlations were found between child age/grade level and improvements in fear and in the mSTAIC states of scared and relaxed, suggesting that the audiobook was more beneficial for older participants. Over 60% of participants liked the audiobook content “a lot” as well as enjoyed listening to the audiobook “a lot.” Without prompting, 15% of participants requested to listen to an additional audiobook.Conclusions: Listening to an audiobook is feasible and could be effective in decreasing fear and state anxiety for children during a waiting period in the PED. The technology is low-cost, simple, and portable. The results of this study should be interpreted with prudence due to the lack of a control group and results that, although significant, were modest based on effect size conventions; future studies should explore the impact of audiobooks on patient stress with an expanded sample size and control group.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

The Impact of Mental Health Services in a Pediatric Emergency Department

2017 ◽  
Vol 33 (5) ◽  
pp. 311-314 ◽  
Author(s):  
Sharon M. Holder ◽  
Kenneth Rogers ◽  
Eunice Peterson ◽  
Robbie Shoenleben ◽  
Dawn Blackhurst
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Services ◽  
Health Services ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
The Impact

Time Motion Study in a Pediatric Emergency Department Before and After Computer Physician Order Entry

2009 ◽  
Vol 53 (4) ◽  
pp. 462-468.e1 ◽  
Author(s):  
Kenneth Yen ◽  
Elizabeth L. Shane ◽  
Sachin S. Pawar ◽  
Nicole D. Schwendel ◽  
Robert J. Zimmanck ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Order Entry ◽  
Time Motion ◽  
Motion Study ◽  
Before And After ◽  
Physician Order Entry

scholarly journals Using the Social Robot NAO for Emotional Support to Children at a Pediatric Emergency Department: Randomized Clinical Trial (Preprint)

2021 ◽  
Author(s):  
Silvia Rossi ◽  
Silvano Junior Santini ◽  
Daniela Di Genova ◽  
Gianpaolo Maggi ◽  
Alberto Verrotti ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Emergency Room ◽  
Randomized Clinical Trial ◽  
Effect Size ◽  
Salivary Cortisol ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Cortisol Levels ◽  
The Impact

BACKGROUND Social robots (SRs) have been used for improving anxiety in children in stressful clinical situations, such as during painful procedures. However, no studies have yet been performed to assess their effect in children while waiting for emergency room consultations. OBJECTIVE This study aims to assess the impact of SRs on managing stress in children waiting for an emergency room procedure through the assessment of salivary cortisol levels. METHODS This was an open randomized clinical trial in children attending a pediatric emergency department. Children accessing the emergency room were randomized to 1 of 3 groups: (1) playing with a NAO SR, (2) playing with a study nurse, or (3) waiting with parents. The salivary cortisol levels of all children were measured through a swab. Salivary cortisol levels before and after the intervention were compared in the 3 groups. We calculated the effect size of our interventions through the Cohen <i>d</i>-based effect size correlation (<i>r</i>). RESULTS A total of 109 children aged 3-10 years were enrolled in the study, and 94 (86.2%) had complete data for the analyses. Salivary cortisol levels significantly decreased more in the group exposed to robot interaction than in the other two groups (<i>r</i>=0.75). Cortisol levels decreased more in girls (<i>r</i>=0.92) than in boys (<i>r</i>=0.57). CONCLUSIONS SRs are efficacious in decreasing stress in children accessing the emergency room and may be considered a tool for improving emotional perceptions of children and their families in such a critical setting. CLINICALTRIAL ClinicalTrials.gov NCT04627909; https://clinicaltrials.gov/ct2/show/study/NCT04627909

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