124 Virtual Reality for Reducing Pain and Perioperative Anxiety in Pediatric Burn Patients

Abstract Introduction One of the most traumatizing and frightening experiences a child can experience is to sustain a burn injury. As a result, the child may experience excruciating pain and anxiety. The objective of this quality improvement project is use virtual reality as a nonpharmacologic intervention for pain and anxiety control and compare to traditional distractions methods. Methods There were 46 subjects ages 4 to 20 enrolled in a sample of convenience. Participants were given either virtual reality or distraction for dressing changes or minor surgical procedures. Before and after the surgical procedure or dressing change, the participants, their parent and nursing staff completed a Modified Yale Perioperative Anxiety Scale (mYPAS, Faces, Legs, Activity, Cry, and Consolability (FLACC) scale or Numeric Rating System (NRS). Results There was no significant difference in FLACC, NRS, and mYPAS scale scores pre-treatment. The post treatment NRS scores were significantly different between distraction and virtual reality (p= 0.031). FLACC scores for the distraction group increased 3.5-fold, while the virtual reality group scores decreased (p.0.0008). Mean mYPAS scores decreased again showing a significant difference between distraction and virtual reality with p= 0.004. The score increased with distraction and decreased with virtual reality with a difference of 12. In all cases virtual reality was better than distraction, when measuring pain and anxiety. Conclusions This QI project demonstrates that VR was more effective in reducing both pain and anxiety in burned pediatric patients as opposed to traditional distraction post treatment. Traditional distraction unfortunately was shown to increase both pain and anxiety post treatment. These conclusions suggest that VR may be utilized as a non-pharmacologic treatment option in conjunction with standard treatment to help decrease pain and anxiety in acutely burned children. Applicability of Research to Practice This study increases the knowledge base and advances the evidence-based practice of advanced practice registered nurses in the specialty of burn care. It suggests that a non-pharmacologic intervention such as virtual reality can be used to effectively reduce pain and anxiety in children who are undergoing treatment for their burn injury.