Implementation of a Preoperative Anxiety Screening Tool for Pediatric Surgical Patients

Background: Recognition of preoperative anxiety in pediatric surgical patients remains ineffective. Undetected preoperative anxiety in a pediatric patient can contribute to postoperative complications, increased patient costs, and reduced nursing staff satisfaction.

Local Problem: More than half of children undergoing planned surgical procedures experience preoperative anxiety. There is no standardized evidence based preoperative anxiety screening tool consistently implemented for pediatric surgical patients at a large academic medical center in central Pennsylvania.

Methods: The Iowa Model outlined the implementation of a preoperative anxiety screening tool for pediatric surgical patients.

Interventions: Education was provided on preoperative anxiety and the State Trait Operation Anxiety-State (STOA-S) questionnaire’s purpose to the pediatric surgical team. The STOA-S was deployed for patients ages 12-18 presenting for a preoperative history and physical appointment over two months. Project observations and feedback were assessed. Data analyses were completed through evaluation of the pre- and post- anonymous questionnaire results, the anonymous questionnaire’s open-ended questions, and the project leads journal. Descriptive statistics were used to evaluate the STOA-S and anonymous questionnaire results.

Results: The completion rate of the STOA-S was 88%. Every patient screened was identified as having mild, moderate, or severe preoperative anxiety at their preoperative H&P appointment. Knowledge, readiness, and awareness increased with p-values <0.05.

Conclusion: The anonymous questionnaire demonstrated that standardizing the use of a preoperative anxiety screening tool was practical. Preoperative anxiety at pediatric surgical patients H&P appointments was identified indicating clinical significance.