WIP 64 - Implementing and Evaluating an Intervention to Improve Child Life Utilization to Mitigate Medical Trauma During Venipuncture for Patients with Sickle Cell: Building a Trauma- Informed Curriculum

Publication Number: WIP 64.7365

Tracy X. Li, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Penelope Grubbs, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Cheryl Dahling, Cincinnati Children's Hospital Medical Center, Ci, OH, United States; Katie Dorn, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Rebekah Doshi, Cincinnati Children's Hospital Medical Center, Florence, KY, United States; Chandra Manuel, Cincinnati Children's Hospital Medical Center, Liberty Township, OH, United States; Paige Chaplin, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Alexandra Power-Hays, Cincinnati Children's Hospital, Cincinnati, OH, United States; Jennifer Rollins, Cincinnati Childrens Medical Center, Liberty Township, OH, United States

Background: Sickle Cell Disease (SCD) affects over 100,000 Americans, with increased incidence among Black race and minority ethnicities. Fear of pain from SCD and medical procedures, exacerbated by distrust or mistreatment in the medical system, may lead to medical trauma and poor healthcare engagement. Children identify venipuncture as one of the most feared healthcare experiences. Early development of coping strategies for pain through anticipatory guidance about venipuncture from child life specialists (CLS) may reduce trauma and increase trust in the medical system.

Objective: To introduce CLS venipuncture anticipatory guidance to families of infants with SCD, as phase one of a trauma-informed, antiracism curriculum. This QI Study aims to reduce venipuncture anxiety and introduce coping strategies for pain through expanded CLS use.

Design/Methods: This QI study’s aim is that 80% of newly diagnosed infants with SCD at Cincinnati Children’s between January 2024 and January 2025 will receive venipuncture anticipatory guidance at their second clinic visit, prior to their first in-clinic lab draw. Zero new SCD patients in the last 2 years met with CLS prior to their first in-clinic lab draw; rather, CLS is often requested in the midst of an attempt. A team of CLS, care managers, and providers was formed. A care manager identifies newly diagnosed infants with SCD and relays the appointment time to CLS. CLS assesses parent attitudes, teaches coping skills, and empowers CLS utilization for future support. A run chart will be created to track CLS visit completion, and periodic meetings will guide PDSA cycles. The intervention’s impact on healthcare experiences will be evaluated through, “Voice of the Customer” interviews in November 2024 and January 2025 with three Likert scale and one qualitative question. These questions include: “how likely are you to ask for support for your child during procedures,” “how stressful is venipuncture for your child,” “do you trust that your SCD team has your best interests in mind,” and “describe a negative and positive experience around lab draws?”.