DNP Graduates – Petronella Stoltz

Petronella Stoltz, DNP
Spring 2014

Abstract Title:
The J Tip Needleless System versus Standard of Care for Venipuncture: Comparison of Procedural Fear and Pain in Pediatric Patients.

Venipuncture procedures are fear inducing and painful for pediatric patients and are recognized as the leading cause of procedure-related pain in hospital settings and pediatric emergency rooms.

The comparison of procedural fear and pain related to venipuncture after the use of the J-tip needleless lidocaine system versus the standard of care (EMLA) in pediatric patients ages 8 years to 18 years. This randomized controlled trial investigated the effectiveness of a needleless system for instilling local anesthetic to numb the skin prior to venipuncture by measuring procedural fear and pain and comparing these outcomes to the standard of care (EMLA).

Pediatric patients aged 8 years to 18 years were randomly assigned to treatment with the J-tip needleless system or to the standard of care (EMLA) prior to venipuncture. Patients rated procedural fear and the pain of the venipuncture procedure using the Children’s Fear Scale (CFS) and a Visual Analog Scale (VAS).

Of the 150 children enrolled, 75 were randomized to the J-Tip group and 75 were randomized to the EMLA group. An analysis of variance for repeated measures (RM-ANOVA) was conducted to compare the effect of the J- tip needleless devices to EMLA on pediatric procedural fear with three different measurements using the Children’s Fear Scale. The results showed that there was no significant interaction between the treatment groups for procedural fear. Both groups showed a reduction in fear using the Children’s Fear Scale from the three time periods which were pretreatment, prior to initiation of venipuncture and post venipuncture.

An independent T-Test was used to compare the effect of the J- tip needleless devices to EMLA on pediatric pain using a Visual Analog Scale. There was a statistically significant difference in the pain scores between the EMLA and the J-Tip group.

This randomized control study found that there was statistically significant difference between the J-Tip and standard of care (EMLA) for pediatric pain and but no statistical difference in procedural fear. The results supported that standard of care (EMLA) provided more effective local anesthetic for venipuncture.