Keep the Momentum Going: Changing Clinicians Perspectives on Needlestick Interventions

Abstract

This evidence-based practice project identifies clinician attitudes and barriers to utilizing needlestick interventions and strategies for sustainability. Needlestick pain and anxiety are prevalent. Since the number of vaccines has increased, needlestick phobia in children and adults has increased. Evidence-based pharmacological and non-pharmacological strategies are available to ease pain and anxiety associated with needlesticks, yet literature indicates these interventions are not routinely offered. Consequences of not offering and utilizing available interventions may result in healthcare delays. Clinics are offered education addressing clinician attitudes surrounding needlestick awareness and provided tools (e.g., pocket guides, scripting) and information on interventions to decrease needlestick pain and anxiety. A toolkit was developed so all locations provide similar, readily available interventions. The curriculum was developed and designed to be delivered over a 6-month timeframe. Clinic leaders and a frontline change champion are identified to support the project and keep the momentum going for sustainment. To decrease access barriers, grant funding for interventions was secured. Prior to the initial education session, clinicians complete a baseline questionnaire focused on available interventions, frequency of educating patients and offering interventions, and needlestick attitudes. After the initial education, clinicians receive additional evidence-based information, from the change champion, at set times over 6 months. Repeat questionnaires are distributed at 3- and 6-months to identify continued barriers and assess perception and practice changes. To date, 9 clinics (n=85 clinicians) have completed the 6-month curriculum with respondent level of agreement and reported practice changes increasing from the baseline to 6-month evaluation. Patient and clinician comments further illustrate the positive impact interventions bring to the experience. Providing ongoing information assists with momentum and allows for systematic implementation, and a change champion is vital for sustainability. Additionally, clinicians reported having resources readily available is imperative. Positive patient/family feedback reinforces the use of evidence-based needlestick interventions.