Implementation of Virtual Reality Pain Alleviation Therapeutic into Routine Pediatric Clinical Care: Experience and Perspectives of Stakeholders
Authors: Girin Helen , Armstrong Megan , Bjorklund Kim A. , Murphy Christopher , Samora Julie B. , Chang Jonathan , Scherzer Daniel J. , Xiang Henry 
Published: March 2024

AbstractAimsTo determine the feasibility of implementing virtual reality (VR) in three pediatric clinical environments during brief, painful procedures outside of research.DesignA quality improvement project with quantitative and qualitative feedback between March and November 2023.MethodsMedical providers (doctors and nurses) implemented VR during brief pediatric medical procedures and completed a demographics and feasibility survey. Qualitative data were obtained from semi-structured interviews after the implementation period.ResultsPatients (n=30) played the VR game during either their medically necessary pin-pulling or needlestick procedures within three clinical environments. Children ranged from 5-16 years and were 50% male. The majority of patients reported enjoyment (mean 8.2 out of 10) with the VR during the procedure and only one minor technical issue was reported. Qualitative data collection showed the benefits of using VR included its ease of use, decreased observed anxiety, and patients had an easier time getting through the medical procedures.ConclusionClinician feedback from the dissemination of VR into pediatric clinical environments showed promising results. Standardized guidelines are needed to further implement VR pain alleviation as standard care in clinical settings.Implications for patient careVR is easy to implement in clinic settings and can improve pediatric patient care during painful medical procedures. Utilizing nurses as champions for novel clinical techniques can assist with transitioning from research to the standard of care.ImpactThe project provided evidence for broader expansion and implementation of VR into different clinical areas. If VR is implemented into daily clinical practice, patients could benefit from reduced pain and anxiety, and medical procedures could be performed more easily than without adjunctive pain/anxiety management.Reporting MethodThis project adhered to the Standards for Reporting Qualitative Research (SRQR) checklist.Patient or Public ContributionNo Patient or Public ContributionWhat does this paper contribute to the wider global clinical community?Medical providers (including nurses) were able to effectively implement VR for pain and anxiety distraction without extending procedure time.Nurses are excellent champions for implementing novel techniques for patient care.Trial and Protocol RegistrationThere is no trial and protocol registration for this project. This project evaluated the feasibility of medical providers implementing VR outside of research. Thus, a structured protocol or trial was outside the scope of the project.Statistics StatementThe authors have checked to make sure that our submission conforms as applicable to the Journal’s statistical guidelines. There is a statistician on the author team (Dr. Henry Xiang). The authors affirm that the methods used in the data analyses are suitably applied to their data within their study design and context, and the statistical findings have been implemented and interpreted correctly. The authors agree to take responsibility for ensuring that the choice of statistical approach is appropriate and is conducted and interpreted correctly as a condition to submit to the Journal.