Implementing a Parental Anxiety Reduction Protocol (PARP) in the Perioperative Period.

PURPOSE: Parents and children often experience anxiety when a child undergoes a surgical procedure. Parental anxiety may influence the child's perioperative experience and has been associated with increased child anxiety, which is linked to adverse postoperative outcomes, including an increased incidence of postoperative delirium, higher pain scores, and a greater need for intraoperative analgesia. The effects of untreated preoperative anxiety may extend beyond the immediate perioperative period and contribute to maladaptive behaviors at home. The purpose of this project was to implement and evaluate a structured protocol designed to reduce parental anxiety during the pediatric perioperative period.

DESIGN

An evidence-based quality improvement project guided by the Knowledge-to-Action model was conducted over a 3-month period at a Level I pediatric trauma hospital. The project targeted parents of children aged 2 to 10 years undergoing outpatient surgical procedures.

METHODS

A Parental Anxiety Reduction Protocol was developed using three evidence-based interventions implemented across the perioperative continuum. The protocol included an educational pamphlet provided to parents at registration, play therapy for children in the preoperative setting, and a meditation video provided to parents during the intraoperative phase. Parental anxiety was measured before and after implementation of the protocol using the State-Trait Anxiety Inventory-6 (STAI-6). Pre- and postintervention anxiety scores were statistically analyzed to evaluate the effectiveness of the protocol.

FINDINGS: Implementation of the Parental Anxiety Reduction Protocol resulted in a statistically significant reduction in parental anxiety scores. Postintervention STAI-6 scores were significantly lower than preintervention scores (P < .001), demonstrating that the multimodal perioperative intervention was effective in reducing parental anxiety.

CONCLUSIONS

A structured, evidence-based perioperative protocol incorporating parental education, pediatric play therapy, and parental meditation significantly reduced parental anxiety among parents of children undergoing outpatient surgery. Reducing parental anxiety may also help mitigate pediatric perioperative anxiety and contribute to improved perioperative experiences and outcomes for children and their families.