Health Care

Children benefit from Via Christi nurse’s pain management efforts

Wendy Mosiman uses a vein finder, a light that helps nurses find veins on other people, on an 8-year-old pediatric patient. Mosiman pioneered a new way of reducing pain using compressed air when giving kids shots. (Feb. 9, 2016)
Wendy Mosiman uses a vein finder, a light that helps nurses find veins on other people, on an 8-year-old pediatric patient. Mosiman pioneered a new way of reducing pain using compressed air when giving kids shots. (Feb. 9, 2016) The Wichita Eagle

When Wendy Mosiman heard the inventor of a needle-free injection system speak at a national conference, she knew she needed to bring the method to Wichita and her patients at Via Christi Health.

“When you see something like that and you’re a pediatric nurse, it’s so exciting,” she said. “Children will tell you that being stuck with a needle, whether for an IV start or a lab draw, is the worst part of a hospital visit.”

J-Tip is a needle-free syringe that uses pressurized gas to force buffered lidocaine to penetrate a patient’s skin before a needle stick. The lidocaine instantly numbs the skin so the patient doesn’t feel the needle.

Mosiman, an advanced practice nurse who serves as a clinical nurse specialist for Via Christi, had recently been taking care of a little girl in the pediatric intensive care unit who was very afraid of needles. Experiences like that and her study of pain management in adults and children helped her understand that needle phobia was real and that a technique to make a needle stick painless was a breakthrough.

“This is a giant issue because needle phobia has become so widespread that it means people don’t get needed health care because they’re so afraid of needles,” she said.

This is a giant issue because needle phobia has become so widespread that it means people don’t get needed health care because they’re so afraid of needles.

Wendy Mosiman, clinical nurse specialist at Via Christi

Mosiman cited a study by Amy Baxter, a nationally known pediatric emergency physician and pain researcher based in the Atlanta area, that shows one in four adults born after 1990 has a needle phobia severe enough to avoid needed medical care. That fear often develops from a traumatic experience as a child.

“People who were born before 1983 got maybe six shots when they were kids, and most of them happened before they can remember. People who were born after 1983 get 20-some shots and they remember a lot of them,” Mosiman said.

Nobody wants to get stuck with a needle, she admitted, but needle phobia is a medical condition recognized in the Diagnostic and Statistical Manual of Mental Disorders. She said there are two kinds: a learned phobia that is psychological and an inherited phobia that is physiological, causing a person to feel weak or faint at the sight of a needle or blood.

People who were born after 1983 get 20-some shots and they remember a lot of them.

Wendy Mosiman, Via Christi nurse

“If you don’t understand how real that fear of needles is in many children, it’s easy to say ‘it’s just a stick, it’ll be over quickly,’ instead of taking the time to make sure that you’ve done everything possible to not make their fear any worse,” Mosiman said. “Statistics show that not taking care of that fear has long-reaching effects. There have been people who have chosen to not have needed dialysis treatment because they didn’t want to be stuck with a needle over and over again.”

Bringing J-Tip to Wichita is one way she can reduce patients’ pain and prevent young patients from learning to fear needles so they don’t become adults who refuse to see a doctor or decline life-saving treatments. Mosiman, who earned her doctorate in pediatric nursing at Wichita State University’s School of Nursing and is an adjunct faculty member there, has spent the past 15 years focused on improving pain management care at Via Christi. She’s led research studies and learned from years of patient care, sharing her knowledge by publishing journal articles, making presentations to healthcare professionals and serving as a resource for nurses helping manage patients’ pain.

The American Society for Pain Management Nursing recognized Mosiman’s work with the National Nurse Exemplar Award for the Pediatric Patient this past fall. A month before accepting the award, she was in Chicago demonstrating the J-Tip method at Ascension Health’s national pain management summit. Via Christi is a member of Ascension, the largest Catholic and largest nonprofit health system in the nation.

1 in 4 adults born after 1990 has a needle phobia severe enough to avoid needed medical care.

Via Christi’s pediatric unit and pediatric intensive care unit have been using J-Tip for six years, replacing a patch that took about an hour to numb an area. Training, funded by Children’s Miracle Network Hospitals at Via Christi, is currently underway at all three Via Christi Wichita emergency rooms, which will use the needle-free syringes before starting an IV, drawing blood or doing a spinal tap on children. Ascension is testing the technique at hospitals in Oklahoma and Tennessee and could eventually use it systemwide at 129 hospitals.

“We have parents in Wichita who are waiting for this program to be expanded to the ERs,” Mosiman said. “If your child has had an IV or a blood draw on the pediatric floor where they’ve used the J-Tip but the next time you come to the hospital and you go down to the ER, you can tell a big difference with your child’s experience.”

Emergency rooms are also being trained to use a comfort hold, a method to keep a child still that has the parent hold the child in a hugging position sitting up. Mosiman said that Children’s Miracle Network consistently supports the hospital’s requests. For example, MRI goggles are now available that allow a child to watch a movie while going through an MRI machine, distracting them so that sedation medication isn’t needed. Also, VeinViewer devices allow nurses to see underneath the skin to find a patient’s veins, improving needle stick accuracy. Down the road, she said, use of the J-Tip system might expand to be used for adults or other pediatric applications.

“I think what we’re doing is just the beginning of a lot of opportunity to take away that needle fear,” Mosiman said. “The J-Tip has received approval for a bigger device that can be used for things like insulin injection. That will be a giant miracle. Think about a 1-year-old who has diabetes and has to have insulin injected three or four times a day. This would inject the insulin underneath the skin without a needle.”

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