Providing Pediatric Training from a Distance

Purpose: This project aimed to provide a virtual, on-demand presence of a certified child life specialist (CCLS) and a pediatric clinical nurse specialist (CNS) to a rural health system in preparation for mass vaccination of children against SARS-CoV-2.

Description: Accidental punctures to patients during injections are often a result of inadequate comfort positioning of the pediatric patient. Comfort positions provide safety, support, and reassurance during stressful or painful procedures. Supine positioning increases distress for the child and decreases their desire to cooperate, while also increasing parent anxiety and decreasing satisfaction. Despite this, many nurses verbalize unfamiliarity with the practice of comfort positions and will resort to antiquated restraining techniques to limit the child’s movement during the procedure. As COVID-19 vaccines were authorized for children ages 5-11 years, a CCLS, pediatric CNS, and pediatric nurse education specialist collaborated to create education and resources to enhance the safety of pediatric patients during vaccination. Recognizing the many steps to a successful vaccination encounter, the team developed a video-on-demand education series that included assessment of the room; methods on how to approach a child, select, and engage a comfort position appropriate for the child’s age and development; and distraction tools, as well as prevention of post-vaccination fainting and falling in teens. A series was created to virtually demonstrate safe and successful comfort positioning options based on the child’s age. Learners were assigned to view the series and they were provided a post-test assessment of their learning.

Evaluation/outcome: The objectives for learners were: 1) describe how to assess the situation and manage room dynamics, 2) describe comfort positions that can be used for various age groups, 3) recognize when to intervene to provide correction and reinforcement of age-appropriate comfort positioning, 4) identify age-appropriate distraction tools, and 5) describe techniques to prevent fainting and falling in teens following vaccination. From November 2021 through November 2022, the post-test assessment was completed by 273 learners. The assessment revealed 94.8% of learners selected “agree” or “strongly agree” when asked if they achieved the learning objectives. 93% of learners agreed or strongly agreed that the format was effective to facilitate their learning. 92% of learners agreed or strongly agreed that the time to complete the activity was acceptable. The video series provided a successful learning activity and was far reaching. The series brought pediatric clinical experts into rural healthcare settings and expedited education in preparation for mass vaccination clinics. From November 2021 to date, the videos have been accessed outside of the assigned learning activity by nearly 500 unique viewers. Colleagues from inpatient pediatric settings have initiated a request to create a similar video series outlining procedures specific to their practice.