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Study finds multicolored scrubs brighten pediatric care

Hospitals can be a frightening place for children, which in turn creates a barrier of distrust nurses must work through in order to provide them with adequate care. However, recently released research suggests nurses can do less scaring and more caring for their facility’s pediatric patients by brightening up their wardrobe.

A study published in the April 2009 issue of the Journal of Clinical Nursing examining the effect of multicolored, nonconventional attire on hospitalized children found it improved children’s and parents’ perceptions of the nurses providing them care. These enhanced perceptions led to increased comfort for the pediatric patients and increased confidence amongst parents of the nurses’ abilities.

“Our goal was to understand the perception of nurses,” says Filippo Festini, BA, BSN, RN, lead author of the study and professor of nursing science at the University of Florence, Italy. “The importance of our findings is that the multicolored uniforms improve the relationship between the nurse and the child, and this helps obtain the child’s compliance to the treatment and reduce anxiety and fear.”

The study was conducted by Festini and his team of University of Florence researchers between July and September 2005 amongst children at Meyer Children’s Hospital in Florence. The researchers surveyed 112 children—ranging from six to 16 years of age—before and after nurses on two pediatric hospital wards swapped their light blue, traditional scrub uniform for nonconventional attire inspired by children’s drawings collected throughout the country (you can view a picture of both uniforms here).

In both instances, researchers asked the children to define the nurses using one word, discovering a higher percentage (96%) used positive words such as “pleasant,” “friendly,” and “helpful” for nurses wearing the new uniforms than when they wore the former (82%).

The study cites “the children also expected the nurses to be ‘funny’ and ‘cheerful,’ and to play with them” when wearing the new uniforms.

While the nursing uniform has dramatically evolved over the past few decades, many nurses still shy away from those splashed with child-friendly prints for fear they detract from their professional image. But that wasn’t the case with the parents in this study.

Researchers asked parents to rate the nurses on a one-to-five scale. Of their findings, parents’ perceptions of nurses’:

  • Adequacy in their role increased from 4.0 to 4.7
  • Ability to be reassuring rose from 4.0 to 4.5
  • Ability to not frighten their child rose from 4.4 to 4.7
  • Ability to be fun improved from 2.3 to 4.6

"By wearing creative and child-friendly scrubs, nurses demonstrate respect for the patients they are caring for and send a message that they understand children and their developmental needs,” says Jill Duncan, RN, MS, MPH, director of the IHI Open School for Health Professions in Cambridge, MA, who has more than 15 years of pediatric-related experience in a variety of acute care settings.

Duncan says nurses can use their scrubs as a discussion starter with their young patients by pointing out drawings or characters and asking the child what he or she sees. “This helps engage the child as well as assure the parents that there is a confident and competent nurse caring for their child,” she says.

Adding color to pediatric care in any uniform

Even nurses who wear monotone scrubs may find benefits incorporating interesting patterns and vibrant colors into their daily practice, says Duncan. Child-friendly drawings in murals, picture books, or paintings can be used as distraction. For example, a nurse can ask an elementary school-aged boy to count the number of trucks he can find while the nurse performs simple assessment skills like counting respirations or listening to breathing sounds. “The child is then more relaxed and the parent is content because their child is not anxious and their care provider has shown he or she is comfortable caring for kids,” Duncan says.

In addition, nurses can calm young patients’ fears and improve their perception of the hospital setting by:

  • Speaking to them at their level
  • Describing interventions using terms and phrases that are meaningful to them given their particular age
  • Giving them options

"A child might not have a choice about taking medicine, but they can decide if they want to take it with apple juice or orange juice, or if they want to sit on Dad's lap or on the chair,” Duncan says. “Give children and parents some control and treat them like partners in discussions and decisions, not just recipients of directions, tasks, and interventions.”