Play is an essential part of providing care to paediatric patients and is used by clinicians to empower children, help them understand interventions and decrease anxiety. During the beginning of the COVID-19 pandemic, the Royal North Shore Hospital (RNSH) Emergency Department (ED) had to make significant operational and geographical changes to adapt and respond to infection control requirements.
Clinicians could no longer offer paediatric patients activities such as books to read, colouring-in supplies, toys to play with or provide access to a designated play area. To ensure patient safety, all communal physical toys were discarded due to the implementation of necessary infection control measures to minimise cross infection. For example, blowing bubbles, once a popular distraction therapy, could no longer be utilised.
These changes made it very challenging for clinicians to provide interactive, stimulating play for paediatric patients within the department. Health professionals, patients and their families alike had commented on how there were limited provisions for play within the department. We realised we were not meeting the needs of the pediatric patients and their families and that we were missing the opportunity to use play to build that important therapeutic relationship.
Providing play in a complex healthcare climate
The ‘Bright lights for kids’ project provides an interactive digital playground that aligns with infection control requirements in the current healthcare climate. The interactive software and projector displays effects that are projected as images onto the floor allowing paediatric patients to interact and play whilst in the ED.
The interactive floor provides clinicians with an opportunity to observe paediatric patients playing and mobilising, assisting in the physical examination. For example, a child with a limp could be observed walking across this interactive floor, providing important clinical information.
The projector is positioned safely in the ceiling within the paediatric ED. The projector software program provides an extensive range of digital effects that include static imagery and video. The display has a wide range of settings from swimming fish to landscapes with animals. The interactive medium allows paediatric patients to venture into a magical world that appeals to their senses and emotions in the ED which can otherwise be a stressful and foreign environment.
The projector has motion detection that turns off when not being utilised or can be run continuously as it seamlessly integrates into the clinical environment.
A successful pitch
We pitched to our districts innovation program and won the people’s choice, which secured funding for the project. We utilised a Brisbane-based company who had successfully installed floor and ceiling projectors in a local public children’s hospital. The projector was installed in the ceiling covered by a clear Perspex. It turns off when not utilised to save on power and energy. The images are projected onto the floor and reactive to the patient’s movement. Hard and software was provided by the company, with installation occurring over a one-day midweek to cause less disruption. When the project was implemented in RNSH ED, it was the first hospital in NSW to create meaningful child-centred play that also adhered to infection prevention and control principals.
Our patient experience officers regularly round and conduct surveys in the department. Initial feedback is positive, with plans to undertake formal evaluation in the near future. We would like to acknowledge the leadership and support of our executive teams who support innovation and creativity. Without the support of the executive team at the NSLHD our previous CE Deb Wilcox and current RNSH General Manger Alison Zecchin.
- Gjærde LK, Hybschmann J, Dybdal D,et al, Play interventions for paediatric patients in hospital: a scoping review, BMJ Open 2021;11:e051957. doi: 10.1136/bmjopen-2021-051957
- Salmela, M., Salanterä, S., Aronen, E.T., 2010. Journal of Advanced Nursing 66.