Discovering successful play strategies for children undergoing invasive procedures

Hospitalisation has long been accepted as a stressful and often fearful experience for children and their families (Kristensson-Hallstrom 2000). One cause of this stress is due to invasive nursing and medical procedures (Fernald and Corry 1981; Broome 1986). Such procedures include intramuscular injection, intravenous cannulation, nasogastric tube insertion, urinary catheterisation, and wound dressings. Currently nurses coordinate and prepare children for these invasive procedures. Procedural play is a potentially valuable intervention aimed at minimising pain, distress and fear and increasing coping competence in children undergoing invasive treatments. The use of procedural play seeks to empower the child by carefully assessing and planning an individualised strategy. This is achieved with reference to the child’s personal preference, developmental stage, the procedure itself and parental judgment. Procedural play strategies may be implemented at various stages of the hospitalisation experience. However, it is important that nurses evaluate a number of evidenced based strategies to provide appropriate techniques to the paediatric population in our care. The literature portrays a variety of evidence to support procedural play practice as an appropriate nursing action. A question still arises in regards to whether these strategies have been tested rigorously enough to promote sound nursing practice. This paper aims to present a range of paediatric procedural play strategies that can be used for preparing children for invasive procedures.