Many adults experience at least some level of anxiety when preparing for a needle procedure — but for young patients, it can be especially traumatic. Often, children’s apprehension originates from a fear of bodily harm, their lack of control over the situation, and their lack of experience undergoing venipuncture.
Often, pediatric needle phobia and anxiety manifests as symptoms similar to a panic attack. A child may exhibit shortness of breath, trembling, increased heart rate, nausea, and even become hysterical — which can reduce IV Insertion success rates. And if you and your team don’t take action to mitigate this fear, your patient could develop a life-long phobia.
Luckily, by developing a poke plan, you can reduce young patients’ fears and help them become more accustomed to needle-based procedures.
Here’s what you need to know to get started:
What is a Poke Plan?
A poke plan is a step-by-step strategy for increasing patient comfort and reducing a child’s fear and anxiety when you and your staff administer vaccinations and perform other needle procedures.
Usually, healthcare organizations prepare a basic plan and then customize the experience for each patient based on their unique wants and needs. In most cases, parents and care providers (including the patient’s doctor, nurse, and/or child life specialist) collaborate on the plan, and, if age-appropriate, they also consult the patient.
For example, you may ask the child if they want to lie down or sit up, which activity they prefer (e.g., TV, book, blowing bubbles, etc.), and whether or not they want their parent or other members of the care team in the room during the procedure.
“The main goal of the [Poke Program] is to engage our young patients and their families to take part in their care,” says Sally Rolston, a pediatric program clinical nurse educator at Trillium Health Partners in Mississauga, Ontario, in an article for Hospital News. “Typically they feel that they don’t have a lot of say about a procedure, and this gives them that opportunity, thereby decreasing anxiety and hopefully any pain that they may experience.”
If the child is too young to understand the procedure, a parent or primary caregiver can supply these details. Then, as the child ages, they can become more involved in their poke plan — which grants them a sense of control.
How to Create a Plan
It’s useful to create a questionnaire for parents/caregivers and children, which you can use to prepare a personalized strategy — and keep in the patients’ chart for future procedures.
Your poke plan should include a few specific elements:
- Previous experience with needle sticks
Has the patient experienced a needle stick before? If so, it’s important to know how they reacted. For example, were they highly fearful and crying? Or were they unconcerned? Generally, past experiences are a good indicator of future behaviors.
- Who should be involved
Does the patient want their parents, siblings or any other trusted members of the staff in the room? For example, some patients will feel more comfortable if a nurse or other healthcare professional they know is with them— even if they’re not the one administering the procedure.
- Patient’s preferred position
Does the patient want to lie flat or sit up? Do they want someone to hold them, or hold their hand? Would they prefer to watch the procedure, or pay attention to something else?
- Patient’s preferred distraction method
Does the patient want to watch TV, play a game on a tablet, read a book, or play with a puzzle or favorite toy? In some cases, parents or caregivers may have additional distraction measures prepared.
- Other appropriate comfort measures
For infants, parents or caregivers may prefer to swaddle them, give them a pacifier, or use sucrose. For older children, deep breathing, imagery, or a favorite song may be better. Additionally, it’s a good idea to double-up comfort measures with a topical anesthetic skin refrigerant.
No matter what pediatric comfort measures your poke plan entails, it’s crucial your patients are as involved as appropriately possible depending on their age. By taking the time to explain the procedure, and offering them a sense of control, they’ll become more comfortable with needle procedures and less likely to become anxious or distressed in the future.
Interested in learning more about improving pediatric comfort measures in your healthcare organization? Check out our free guide now.