At their fingertips: The effects of child-led distraction using a tablet computer on children’s distress and pain during painful medical procedures; a randomised controlled trial.

This study will be conducted in a Western Australian tertiary paediatric hospital within the Ambulatory Care Day-stay Facility (ACDF) by a Registered Nurse/Researcher. A randomised controlled trial with one control group and one experimental group will be undertaken. The experimental group will receive ‘standard care’ from their parents and healthcare professionals and the distraction of the tablet computer (Apple iPad) to self-lead their own distraction. The tablet computer will be offered to the child upon entering the treatment room in view of the intravenous cannulation procedure. The tablet computer will be provided 5 minutes prior to the commencement of the procedure to allow the child time to familiarise themselves with the tablet computer and decide on a distraction. The tablet will be returned on completion of the procedure. A wide number of age-specific applications will be uploaded onto the tablet computer with audio, visual, audio-visual and virtual reality applications from which to choose. Time spent engaging with the iPad will be collected over four time points including prior to insertion of needle (from the time the nurse enters the room to the time the needle is inserted); during the needle insertion (whilst the needle is being inserted to the time the needle has been placed in a vein and deemed complete); after the needle is inserted (From the time the needle is placed into the vein until the dressings have been applied and the procedure is deemed complete) and total time spent engaging with the iPad. This will be collected by the researcher and will allow the assessment of intervention adherence/fidelity. Parents/guardians are permitted and encouraged to engage with the tablet computer with their child. The control group will receive ‘standard care’ from their parents and health professionals. Standard care is described as standard treatment during medical procedures including local anaesthetic cream (EMLA), parental and professional reassurance, encouragement, involvement and comforting. Stratified randomisation will be used to allocate the children to the control or intervention group by a computer generated program to ensure that equal numbers of participants of similar ages are allocated to each group.