Authors (including presenting author) :
YEUNG MK, LEUNG MPS, LAI PY, CHING YT
Affiliation :
Accident and Emergency Department, Princess Margaret Hospital
Keyword 1: :
Emergency Department
Keyword 2: :
Minor Procedures
Keyword 3: :
Video Distraction
Keyword 4: :
Patient Experience
Keyword 5: :
Anxiety Reduction
Keyword 6: :
Continuous Quality Improvement
Introduction :
Minor procedures performed in the A&E setting are clinically routine but can be highly anxiety‑provoking for patients. In a fast paced and unfamiliar environment, procedures such as wound suturing, incision and drainage and minor orthopaedic interventions may heighten fear, amplify pain perception and hinder cooperation. These factors can reduce patient satisfaction and increase the workload for nursing staff. Non‑pharmacological approaches, particularly psychological distraction, are recognised as effective adjuncts for reducing procedure‑related anxiety and perceived pain. Tablet based Multimedia distraction is low‑risk, cost-effective, and easily integrated into routine care. Whilst there was no previously existing structured protocol in the PMH A&E, the “Minor Procedure Smiley” CQI project introduced a standardised iPad‑based distraction workflow in the Minor OT and evaluated its impact on both patients and staff.
Objectives :
1. Reduce procedure‑related anxiety and perceived pain among patients undergoing minor procedures. 2. Enhance the overall patient experience by providing a more reassuring environment. 3. Assess the intervention’s perceived impact on nursing workflow, patient cooperation and patient–nurse relationship. 4. Generate evidence to guide continued use and potential scaling‑up of multimedia distraction for minor procedures.
Methodology :
This prospective CQI project was conducted in the PMH A&E Minor OT. A standardised protocol outlined device set up (mounted or hand held), infection‑control measures and daily functional checks performed by designated nurses. Nurses introduced the intervention, assisted patients in selecting age‑appropriate content, and ensured playback began before and continued throughout the procedure. Use of distraction was documented. Post‑procedure, patients completed a seven‑item questionnaire; A&E nurses involved in minor procedures completed a separate survey. Descriptive statistics were applied.
Result & Outcome :
Over a 2.5-month trial from mid-February to late-April, 2025, 41 patients received the intervention and 32 questionnaires were returned (78%). All respondents found distraction at least somewhat helpful; 90.7% reported some degree of pain relief and 96.9% noted reduced anxiety. Overall satisfaction was 100%, and all patients indicated they would use the intervention again. Paediatric patients tended to provide the most positive ratings. Only one participant reported disturbance from online advertisements; no other technical issues were noted. Fifteen nurses completed the staff questionnaires. Median Likert scores (IQR) were 5 (4–5) for pain reduction, 5 (5–5) for anxiety reduction, 5 (4–5) for smoother procedures, 5 (4–5) for improved cooperation, 5 (5–5) for enhanced satisfaction and 5 (4–5) for ease of integration. No significant technical or infection‑control concerns were reported. Given the consistently favourable findings, the video‑distraction protocol has been adopted as standard practice for eligible minor procedures in the PMH A&E.
