1. Do Child Life Specialists Decrease Anxiety in Pediatric Patients? NSG Tracy Giraud Ferris State University NSG Tracy Giraud Ferris State University

2. Introduction In hospitalized pediatric patients, do child life specialists decrease anxiety and the need for anesthesia? Hospital admissions and procedures are very stressful for children and their families. If the child’s experience is positive the procedure may be seen as tolerable to the patient which will allow the staff to work with the patient in calm environment. A calm environment will decrease the child’s anxiety. Introduction In hospitalized pediatric patients, do child life specialists decrease anxiety and the need for anesthesia? Hospital admissions and procedures are very stressful for children and their families. If the child’s experience is positive the procedure may be seen as tolerable to the patient which will allow the staff to work with the patient in calm environment. A calm environment will decrease the child’s anxiety.

3. Literature Review Initially, there were ten articles chosen for this paper. These articles were critiqued based on the Nursing 350 article critique rubric. Four articles were chosen based on the current and relevant information they offered in reference to the topic with credible sources and authors and the appropriate methodology in relation to the topic. Initially, there were ten articles chosen for this paper. These articles were critiqued based on the Nursing 350 article critique rubric. Four articles were chosen based on the current and relevant information they offered in reference to the topic with credible sources and authors and the appropriate methodology in relation to the topic.

4. Article Review Article #1 Child Life Services This article was written by the Child Life Council, Committee on Hospital Care, from the American Academy of Pediatrics. This article reviewed the therapeutic interventions of child life specialists as they related to the individual experience of each child and concluded that child life services may help to contain costs by reducing hospital length of stay and decreasing the need for analgesics. Observation and consumer satisfaction feedback further confirm the positive effects of child life programs on children, families, and staff. (Child Life Council, 2006). Decreased length of stay brings more money to the hospital which will allow them to afford the Child Life Specialist. Article #1 Child Life Services This article was written by the Child Life Council, Committee on Hospital Care, from the American Academy of Pediatrics. This article reviewed the therapeutic interventions of child life specialists as they related to the individual experience of each child and concluded that child life services may help to contain costs by reducing hospital length of stay and decreasing the need for analgesics. Observation and consumer satisfaction feedback further confirm the positive effects of child life programs on children, families, and staff. (Child Life Council, 2006). Decreased length of stay brings more money to the hospital which will allow them to afford the Child Life Specialist.

5. Article Review Article #2 Child Life Specialists Help Young Patients Cope with Illness This article was written by Jenny Gold of Kaiser Health News, December 12, 2012. This article studies the impact of child life specialists as it relates to productivity and patient safety during different patient procedures and surgeries. The study found that the work of a child life specialist can save 3-5 minutes per child/patient, which allows them to add another surgery to the schedule each day. (Gold, 2012). Child life specialists allow the patients to be more relaxed which decreases anxiety and allows a smooth transition into a surgery/procedure. When you add that to positive family surveys and positive feedback regarding an experience, hospitals will be more willing to make sure they can afford to keep child life specialists on staff. Article #2 Child Life Specialists Help Young Patients Cope with Illness This article was written by Jenny Gold of Kaiser Health News, December 12, 2012. This article studies the impact of child life specialists as it relates to productivity and patient safety during different patient procedures and surgeries. The study found that the work of a child life specialist can save 3-5 minutes per child/patient, which allows them to add another surgery to the schedule each day. (Gold, 2012). Child life specialists allow the patients to be more relaxed which decreases anxiety and allows a smooth transition into a surgery/procedure. When you add that to positive family surveys and positive feedback regarding an experience, hospitals will be more willing to make sure they can afford to keep child life specialists on staff.

6. Article Review Article #3 A Coping Mechanism: Child Life Specialists Can Ease Hospital Stays for Pediatric Patients This article was written by Gretchen Henkel of ENT Today, December, 2010. This article discusses how child life specialists have become important members of the multidisciplinary team, working with parents as well as children. The anxiety of parents will decrease when they are able to help their child find a way to be calm through a procedure. When parents are happy, surveys and hospital scores increase. Hopefully in time, all hospitals/health care facilities will see importance of child life specialists. Article #3 A Coping Mechanism: Child Life Specialists Can Ease Hospital Stays for Pediatric Patients This article was written by Gretchen Henkel of ENT Today, December, 2010. This article discusses how child life specialists have become important members of the multidisciplinary team, working with parents as well as children. The anxiety of parents will decrease when they are able to help their child find a way to be calm through a procedure. When parents are happy, surveys and hospital scores increase. Hopefully in time, all hospitals/health care facilities will see importance of child life specialists.

7. Article Review Article #4 Child Life Specialists Help Sick Kids Be Kids This article was written by Jenny Gold, July 23, 2012. This article examines the interaction of child life specialists and patients just prior to surgery. There was a positive impact on the cooperation of the patients with the staff, which saves time and creates a positive experience for the patient. Per Dr. Shah, when the child life specialists aren't available, "It's hard. You're pulling [children] sometimes away from the parents. The parents are upset. The child is upset. It heightens their anxiety. You bring them back to the operating room, and it's a lot harder to put them back to sleep. It's a lot harder to give them an IV." (Gold, 2012). Article #4 Child Life Specialists Help Sick Kids Be Kids This article was written by Jenny Gold, July 23, 2012. This article examines the interaction of child life specialists and patients just prior to surgery. There was a positive impact on the cooperation of the patients with the staff, which saves time and creates a positive experience for the patient. Per Dr. Shah, when the child life specialists aren't available, "It's hard. You're pulling [children] sometimes away from the parents. The parents are upset. The child is upset. It heightens their anxiety. You bring them back to the operating room, and it's a lot harder to put them back to sleep. It's a lot harder to give them an IV." (Gold, 2012).

8. Analysis of Evidence Analysis of the Evidence These articles have demonstrated the importance of child life specialists in pediatric health care settings. Surveys prove satisfaction among parents and patients. The use of child life specialists decreased the need for anesthesia during procedures and treatments. For example, child life specialists would talk to patients during IV insertions as parents hugged them. The IV insertion was done without incident and quicker than when the specialists were not involved. By decreasing the anxiety of families and patients allows physicians to stay on schedule and even add more procedures each day. Increasing the number of procedures done each day will add to the revenue of the hospital, which gives incentive for hospitals to make sure that they keep child life specialists on staff. Knowing that hospitals are a business, they are concerned about money and how to save. Decreasing the need for anesthesia will decrease the amount of money going out of each unit. Analysis of the Evidence These articles have demonstrated the importance of child life specialists in pediatric health care settings. Surveys prove satisfaction among parents and patients. The use of child life specialists decreased the need for anesthesia during procedures and treatments. For example, child life specialists would talk to patients during IV insertions as parents hugged them. The IV insertion was done without incident and quicker than when the specialists were not involved. By decreasing the anxiety of families and patients allows physicians to stay on schedule and even add more procedures each day. Increasing the number of procedures done each day will add to the revenue of the hospital, which gives incentive for hospitals to make sure that they keep child life specialists on staff. Knowing that hospitals are a business, they are concerned about money and how to save. Decreasing the need for anesthesia will decrease the amount of money going out of each unit.

9. Application of Evidence Physicians are beginning to accept child life specialists as an integral part of the health care team. Educating patients and families before a procedure/treatment, decreases anxiety and increases the amount of cooperation of the patient and allows the procedure to happen without incident. This allows staff to increase the number of procedures per day, increasing revenue. Currently, the work of a child life specialist is not billable. Increasing revenue will hopefully free up enough money to cover the cost of keeping child life specialists on staff. Application of Evidence Physicians are beginning to accept child life specialists as an integral part of the health care team. Educating patients and families before a procedure/treatment, decreases anxiety and increases the amount of cooperation of the patient and allows the procedure to happen without incident. This allows staff to increase the number of procedures per day, increasing revenue. Currently, the work of a child life specialist is not billable. Increasing revenue will hopefully free up enough money to cover the cost of keeping child life specialists on staff.

10. Summary Summary Statements In summary, child life specialists decrease anxiety and allow staff to perform efficiently. Inserting IVs, assisting a patient during procedures/treatments without incident makes the work day for nursing and other staff much more productive. This creates a better experience for staff and patients. Hopefully, as the work of child life specialists continues, the insurance companies will begin to see the importance of their work and consider reimbursement for their services. Summary Statements In summary, child life specialists decrease anxiety and allow staff to perform efficiently. Inserting IVs, assisting a patient during procedures/treatments without incident makes the work day for nursing and other staff much more productive. This creates a better experience for staff and patients. Hopefully, as the work of child life specialists continues, the insurance companies will begin to see the importance of their work and consider reimbursement for their services.

11. References Child life services, (2006). American Academy of Pediatrics. 118,(4), 1757- 1764. doi: 10.1542/peds.2006-1941. http://pediatrics.aappublications.org/content/118/4/1757.abstract Gold, J.,(July 23, 2012). Child life specialists help sick kids be kids. Kaiser Health News, July 23, 2012. Gold, J.(2012). Child life specialists help young patients cope with illness. Kaiser Health News, Dec.4, 2012. http://www.washingtonpost.com/national/health-science/life-specialists- help-young-patients-cope-with-illness/2012/12/03/8c8dd334-f064-11e1- ba17-c7bb037a1d5b_story_1.html Henkel, G.,(2010). A coping mechanism: child life specialists can ease hospital stays for pediatric patients. ENT Today. Dec, 2010 http://www.enttoday.org/details/article/884821/A_Coping_Mechanism_C hild_life_specialists_can_ease_hospital_stays_for_pediatric_.html References Child life services, (2006). American Academy of Pediatrics. 118,(4), 1757- 1764. doi: 10.1542/peds.2006-1941. http://pediatrics.aappublications.org/content/118/4/1757.abstract Gold, J.,(July 23, 2012). Child life specialists help sick kids be kids. Kaiser Health News, July 23, 2012. Gold, J.(2012). Child life specialists help young patients cope with illness. Kaiser Health News, Dec.4, 2012. http://www.washingtonpost.com/national/health-science/life-specialists- help-young-patients-cope-with-illness/2012/12/03/8c8dd334-f064-11e1- ba17-c7bb037a1d5b_story_1.html Henkel, G.,(2010). A coping mechanism: child life specialists can ease hospital stays for pediatric patients. ENT Today. Dec, 2010 http://www.enttoday.org/details/article/884821/A_Coping_Mechanism_C hild_life_specialists_can_ease_hospital_stays_for_pediatric_.html