Introduction
Patients with developmental disabilities commonly experience psychological distress
during health care visits. There is limited research describing which individualized
interventions are being implemented to promote optimal care in the perioperative area.
Method
In this prospective observational study of 60 patients with developmental diagnoses,
aged 3–21 years, we recorded adaptive care plan (ACP) interventions and assessed family
experience.
Results
Patients receiving ACPs had diverse diagnoses, including autism spectrum and 10 other
unique syndromes. Most patients received previsit planning (90%), adaptations to standard
protocols (60%), child life specialist preparation (67%), procedural support (90%),
and were given fast-acting anxiolytics before anesthesia induction (68%). Families
reported that ACPs were important for managing a child's stress (94%) and promoting
safety (92%).
Discussion
ACPs promote safe, productive health care encounters for patients with various diagnoses,
ages, and coping abilities. Families find ACPs important for stress management and
promoting safety.
KEY WORDS
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Biography
Abby V. Winterberg, Nurse Practitioner, Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, and Affiliate Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, OH.
Biography
Emily Jones, Certified Child Life Specialist, Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Biography
Lili Ding, Biostatistician, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, and Research Associate Professor-Affiliate, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Biography
Lauren M. Hill, Registered Nurse, Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Biography
Anna M. Varughese, Anesthesiologist, Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, and Professor, Department of Anesthesiology, College of Medicine, University of Cincinnati, Cincinnati, OH; Director of Perioperative Quality and Safety, Department of Anesthesiology, Johns Hopkins All Children's Hospital, St. Petersburg, FL; Associate Professor of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.
Article info
Publication history
Published online: June 26, 2022
Footnotes
This work was supported by internal funding (the Carolyn Stoll Nursing Research Fund, Department of Patient Services and the Department of Anesthesiology, Cincinnati Children's Hospital) and funding from the Association of periOperative Registered Nurses Competency & Credentialing Institute research grant. For database support (Research Electronic Data Capture), this project was supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under award no. 5UL1TR001425-03.
Conflicts of interest: None to report.
Identification
Copyright
Copyright © 2022 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
