Reducing Pediatric Vaccine-Associated Pain Using The Buzzy

Abstract

Background: Vaccinations are recognized as a major cause of iatrogenic pain in childhood. Currently no pain management protocol exists at a large suburban pediatric primary care clinic in the mid-Atlantic, for children undergoing vaccination. Local Problem: The purpose of this DNP project was to implement and evaluate the usage of the Buzzy device during vaccination of children ages 4-17 years, at this pediatric primary care clinic. Buzzy is an effective combination of vibration and external cold analgesia, which significantly reduces injection pain in children. The project was designed to improve patient care at this clinic, by addressing the pain management needs of children undergoing vaccination. Interventions: The project took place over the course of 16 weeks. During the first two weeks, the project leader posted Buzzy advertisements throughout the clinic and distributed brochures to families. Nurses (n = 11) and medical assistants (n = 1) were individually trained during this time, regarding proper technique and usage of the device. During weeks 3-16, the nurses and medical assistant utilized Buzzy when vaccinating children ages 4 to 17 years. The project leader collected data using two audit tools: (1) a running log documented by the nurses/MA that tracked the number of patients receiving the Buzzy intervention, and (2) a running log documented by the project leader that randomly tracked those who utilized Buzzy. Staff provided a satisfaction survey to each patient who received Buzzy during vaccination that was submitted anonymously prior to patients leaving the clinic. During weeks 3-16, the project leader reviewed and entered data into an Excel spreadsheet and conducted an analysis of data utilizing descriptive statistics. Data was also analyzed via a run chart to track Buzzy usage and to identify trends over the course of the 14-week period. Results: Staff offered Buzzy to a total of 761 patients. Six hundred and eighteen patients used the device during vaccination, while 143 patients declined. The mean number of patients using Buzzy per week was 43. A total of 523 surveys were completed, yielding an 84.6% survey response rate. Ninety-seven percent of parents and patients surveyed reported satisfaction with their vaccination experience using Buzzy, which well surpassed the project’s goal of 50%. One hundred percent of nurses (5 out of 5) offered Buzzy to patients during audit weeks 3, 5-9, 11 and 14. The satisfaction rate among nurses who utilized Buzzy ranged from 67% during week 4, to 100% during weeks 6-16. Conclusion: The positive response from patients, parents, and staff demonstrates the device’s efficacy and the success of this project, and will aid in its sustainability at this clinic. With continued provider and nursing support, Buzzy has potential to become standard of care during vaccination at this clinic. Implications for future research include use of the device on a younger population of patients, application during additional needle stick procedures, as well as incorporating Buzzy usage into the clinic’s EHR. This project can be utilized as a model for pediatric clinics seeking methods to decrease vaccine-associated pain for their patients.