RICHMOND (WWBT) - Taking a child to the hospital emergency room is a very stressful event for everyone involved. Parents are understandably worried about the health and safety of their son or daughter, and the child may be very anxious about the type of treatment that will be provided by the doctor or nurse.
All of these very normal concerns are compounded significantly for pediatric patients with Autism Spectrum Disorders or ASDs. Some unique challenges for these children can include not wanting to be touched, an inability to communicate verbally and refusing to sit still for necessary procedures such as drawing blood or checking vital signs.
These behaviors can often mask a medical condition that needs to be treated in the emergency department (ED). Having identified a real need to better support our patients with ASDs, the nurses in the Bon Secours St. Mary’s Hospital Pediatric ED, who are specially trained to work with pediatric patients, began to seek an innovative solution.
One of our clinical nurses, Deborah “Deb” Alder, BSN, RN, CPN, brought forward and conducted extensive research on the idea of a sensory disorder cart, also called the sensory cart, that is especially designed for patients with ASDs. With Deb’s ingenuity and leadership as a catalyst, we believed that the sensory cart would appeal to children of all ages on the autism spectrum and also would attempt to meet their needs through an assortment of tactile, auditory, oral, olfactory and visual tools.
Following a comprehensive review of the latest evidence-based literature, our hospital’s Unit Council agreed to implement the sensory cart to improve the quality of life for the child and their caregivers. Quite simply, the sensory cart is a mobile cart, similar in size to a standard-sized code cart, which contains a variety of age-appropriate tools and items that target ASD sensory disorders.
After a thorough assessment of the child, which includes a collaborative conversation with the caregiver, the emergency department nurse determines which tool would be the best choice to provide relief of the patient’s sensory dysfunction.
Tools in the sensory cart include:
- Visual: Multi-color LED finger flashlights, handheld light-up wands, plastic snow globe bottles, glitter and light-up wands, soft-tipped pinwheels
- Auditory: White noise machines, music, egg shakers
- Tactile: Silk scarves, textured stress balls, flexible accordion popping tubes, stuffed animals, chew toys, foam sticks, fidget spinners, fidget tangle puzzles
- Olfactory: Lavender scents
Our nurses use the cart primarily for intravenous placement procedures and taking vital signs during triage. We quickly recognized that a child whose sensory needs were met with the proper tools was calmer and more cooperative during the care that the nurses were providing. In fact, the cart has been proven to be more widely used than we initially expected.
The sensory cart also has been beneficial for patients who do not have a formal diagnosis of ASD as well as other patients needing specific sensory distractions. Since implementation of the sensory cart, the Pediatric ED patient satisfaction score related to “nurses’ attention to needs” increased from 76.9 percent to 91.3 percent.
More importantly, the development of the sensory cart for a child with ADS has helped to provide a calm and soothing environment, which has allowed the medical team to perform the tasks necessary to care for the child holistically.
The Emergency Nurses Association honored Bon Secours St. Mary’s Hospital’s Pediatric ED with the Lantern Award, which recognizes emergency departments that demonstrate exceptional and innovative performance in leadership, practice, education, advocacy and research. It honors accomplishments in incorporating evidence-based practice and innovation into emergency care and is a symbol of a hospital system’s to quality, safety and a healthy work environment. The sensory cart was one of the innovative initiatives that we showcased to win this prestigious award.
I’m so proud of Deb and our creative team of emergency nurses who share a true passion for their profession. They provide high quality, personalized and specialized care for the youngest members of the Richmond region and central Virginia.
Thanks to their dedication and commitment to family-centered care, the sensory cart has become an indispensable piece of equipment in the Bon Secours St. Mary’s Pediatric ED.