Cruisin'

Five-year-old Malaya Morgan drove herself to the operating room in a pink Mercedes recently to get a tonsillectomy.

Well, Malaya wasn’t actually driving…an OR nurse was guiding the vehicle with a remote-control device…but don’t tell Malaya that—as far as she was concerned, she was doing the steering.

Malaya traveled the long hallway from the Same Day Surgery (SDS) area to the operating room in a Power Wheels battery-operated toy car, one of four vehicles in an SDS fleet made possible by generous donors.

“The Power Wheels have been a big hit for our kiddos,” said Stacey Murr, MSN, RN, CPN, Director of Nursing, SDS/PACU. Stacey and Megan Jackson, RN, MSN, CNOR, drove the project.

Patients who fit safety criteria can travel the last leg to the OR by picking a vehicle from the SDS “parking lot.”

“The kiddos enjoy driving, including all of the positive attention they receive as they travel down the hallway,” Stacey said. “This allows our patients to have a choice on their surgery day, and it involves them in the coordination their experience."The fun of “driving” diverts attention from the stress of an impending surgical procedure, both for patients and parents…and that’s the real purpose of the project.

“It’s a distraction method, in a child-friendly way, that makes the situation less scary,” Stacey said. “It really helps them as they’re going to the OR and their parents are going in another direction. On most occasions, they’ve forgotten that mom and dad are in the waiting room by the time they get to their OR!”

A parent survey was conducted, and the results were “overwhelmingly positive,” Stacey said. In fact, the idea for the Power Wheels originally came from parental feedback. A Children's Mercy staff member submitted the idea as part of Children's Mercy's Lean System; after vetting the concept, a pilot program was established in Perioperative Services last fall.

The vehicles were such a hit and the pilot went so well that Perioperative Services has been able to open eligibility to all surgerical clients who meet the following criteria:

• Patients must be age 3 to 8 years old;
• 70 lbs. or less;
• No medical equipment attached (such as IVs or home vents)
• Not in isolation precautions; and
• Not receiving pre-op medication for anxiety (We don’t want any DUIs!)

Power Wheels vehicles aren't the only distraction to help alleviate anxiety prior to surgery. Before Malaya got behind the wheel, she enjoyed playing "Dress-Up Barbie" on an IPad.

"We don’t typically start IVs in Same-Day Surgery,” Stacey said. “Our kiddos go to the OR and go to sleep with an anesthetic gas first so they don’t have to experience the needle poke while they’re awake. Adults typically receive medication up front, but unless there’s a medical necessity to have an IV before induction, our patients don’t have to, and if they do, there’s an option to take a medication by mouth for most cases.”

Tonsillectomies, ear tube procedures, dental surgery and hernias are among the typical procedures where eligible patients can choose to go to the OR in a Power Wheels vehicle, “But we really want to be able to offer it to all of our surgical clients,” Stacey said. “In the age range from 3-8, it really could be utilized for anything.”

This innovative distraction method is used in other Children’s Hospital Association institutions. “We’re super excited,” Stacey said. “It’s playful, a nice conversation starter for a child or parent who is anxious, and is one of the ways we can offer a child a way to ease a scary situation.”

Learn more about Same Day Surgery at Children's Mercy.