Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-7-2026

Graduate Advisor

Charity Galgani, DNP

Co-Advisor

Jinnie Tkach, DNP

Committee

Charity Galgani, DNP

Jinnie Tkach, DNP

Jessica Peuterbaugh, DNP

Abstract

Problem: Pediatric surgical procedures are associated with preoperative anxiety. Preoperative anxiety is associated with higher postoperative pain. Multiple studies have found that decreasing preoperative anxiety using Virtual Reality (VR) Intervention also decreases postoperative pain scores and use of rescue analgesics in postoperative care units (PACU). However, there is no standardized protocol for use of VR interventions and in our institution, VR was not utilized at all.

Methods: This quality improvement (QI) initiative utilized a quasi-experimental design and convenience sampling. Quantitative data was collected during visits for scheduled operative visits for pediatric surgical patients ages seven to 18 years of age. Data collected included the number interventions implemented, demographic data, operative information including type of procedure, preoperative anxiolytic and postoperative rescue analgesic administration, and PACU pain scores. Using retrospective chart review, comparison data were pulled for a similar group of surgical patients from the months prior to initiation of the QI project.

Results: During this QI initiative, a total of 40 (n = 40) patients received VR intervention. Pain scores and rescue analgesic doses were not statistically significantly different between groups. Patients and families did express satisfaction and decreased anxiety, demonstrating clinical significance of the project.

Implications for Practice: Based on clinical significance and small sample size of the initial cohort, further plan-do-study-act (PDSA) cycles are warranted. Additional modifications should include pre-and post-intervention anxiety surveys and satisfaction.

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