For nine-year-old Stella, the fear of needles once made routine vaccinations a stressful experience. “I am afraid of the unknown. I am afraid of those sharp objects,” she said. Her experience is one Children’s Hospital at London Health Sciences Centre (LHSC) hopes to change through the expansion of its Comfort Promise program. Originally introduced for intravenous (IV) insertions, the program has expanded as of July 1 to nearly every area of Children’s Hospital where children undergo needle-related procedures, regardless of the reason for their visit. “We wanted to find a way to use pharmacologic and non-pharmacological approaches, empowering the caregivers, empowering our frontline nurses to comfort children during needle related procedures,” said Dr. Naveen Poonai, a physician at Children’s Hospital. The Comfort Promise combines evidence-based strategies to reduce pain and anxiety in infants and young children. “It’s a hospital-wide, lean quality improvement initiative that uses bundled care, which is an anesthetic on the skin, which we call a topical anesthetic, distraction, which is up to the parent and the child, comfort positioning, which is also up to the parent and the child, and sucrose, which is actually sugar, which is a pain reliever in kids under the age of 12,” Poonai said. According to Children’s Hospital, research shows more than 75 per cent of children experience pain during hospital stays, with needle procedures ranking among the most painful aspects of their care, second only to the medical condition itself. Poonai said painful medical experiences in childhood can have lasting effects, including slower recovery, increased sensitivity to pain during future procedures and a greater likelihood of vaccine hesitancy. For Stella and her mother, the program made a significant difference. “They welcomed her. They knew what she was already nervous about, and they made her feel comfortable instantly. They waited until she said go. And then they gave her the needle. It was the easiest thing I’ve ever experienced. I cried with relief, and she felt so proud at the end,” her mother said. The Pediatric Vaccination Clinic has already incorporated Comfort Promise strategies, and with the hospital-wide expansion, staff hope more children will have positive experiences with medical procedures that are often associated with fear and pain. Hospital officials say the goal is to make needle-related care more comfortable while helping children build confidence and reducing anxiety during future medical visits.
