Does the Use of Healing Touch Decrease Anxiety, Decrease Emergence Delirium/Emergence Agitation and Decrease Length of Stay in Preschool Tonsillectomy

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Does the Use of Healing Touch Decrease Anxiety,
Decrease Emergence Delirium/Emergence Agitation
and Decrease Length of Stay in Preschool
Tonsillectomy Adenoidectomy (TA) Patients in
the Post Operative Anesthesia Care Unit?
(PACU)Wendy Grace Rolf RN, MSN, CHTP,
AHN-BC
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What Is Energy MedicineBiofield Medicine ?
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Healing Touch

• Healing Touch is a biofield therapy that is an
  energy-based approach to health and healing. It
  uses touch to influence the human energy system.
• The energy system
• energy centers,
• the fields that surround the body,
• the meridians.

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Goal of Healing Touch

• Goal restore harmony and balance
• Healing Touch complements conventional health
  care

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PICO Question

• P (population) Pediatric Post Operative TA
  Patients
• ages 3 - 6
• I (intervention) Healing Touch
• C (comparison) No Healing Touch
• O (outcome)
• Decrease post op anxiety
• Decrease emergence delirium/emergence agitation
• Decrease time to meet PACU discharge criteria

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Outcomes

• Anxiety- Patients Familys
• Ease of Wake Up--Emergence Delirium/Emergence
  Agitation
• Patient Flow- Earlier Discharge to home
• Increase Patient And Family Satisfaction

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CCHMC Vision Mission2010

• Cincinnati Childrens Hospital Medical Center is
  committed to improving childrens health and
  CCHMC values the patients and familys positive
  experience and quality of life.

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Arrive in PACU after TA Surgery Complete
Healing Touch Done
Improved Ease of Wake Up Less Emergence Delirium
Agitation
Less Anxiety
Earlier Discharge to Home
Parents More Satisfied
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Review of LiteratureWeight of the Evidence

• CINAHL, MEDLINE, Cochrane, EBSCO, PUBMED, OVID,
  Centre for Reviews
• Dissemination, Healing Touch International,
  Healing Touch Program, Dissertations,
• NACHRI
• 1960-PRESENT
• TERMS
• Healing touch
• Reiki
• Bioenergy
• Energy medicine
• Energy therapies
• Energy healing
• Children
• Anxiety
• Anxiety in hospitalized children
• Relaxation
• Pain
• Surgery
• Emergence delirium

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Findings

• 62 articles reviewed
• 10 most recent highest level that addressed
  PICO question
• 3 Meta-analysis or SR
• 3 RCTs
• 3 descriptive studies
• 1 Qualitative
• 3 CCHMC PACU staff surveys
• 1 CCHMC Retrospective Study (Unpublished)
• 2 NACHRI Responses

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Synthesis of Evidence

• High grade of evidence to support the safety of
  Healing Touch with adults and children (Jain,2010
  1a Lee, (2008) 1a So, 2008 1a Whitley,
  2008 1a).
• High grade of evidence to support Healing Touch
  for pain and anxiety with adults (Jain,2010 1a
  Lee, 2008 1a So, 2008 1a).
• High grade of evidence to support the use of HT
  to decrease stress with premature infants
  (Hanley, 2008 2a Im, 20092b Whitley, 2008
  2a).
• Moderate evidence that Healing Touch may decrease
  the length of stay (MacIntyre, 2008 2a).
• Moderate evidence to support the use of Healing
  Touch with childrens stress anxiety (Kramer,
  1990 4b Kemper, 2009 4a Zimmer, 2008
  Unpublished).

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Evidence Summary

• Healing Touch may decrease the childs anxiety
  and support the ease of wake up from anesthesia
  which may lead to earlier discharge to home.
• There is evidence that supports the use of
  Healing Touch and other biofield therapies with
  adults but little research has been done with
  children. To date, there has been no published
  research with HT and post operative pediatric
  patients (Healing Touch International Research
  Survey 2010).

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Recommendations

• Research is needed to answer clinical question
• Submit research proposal to IRB for a a
  prospective, repeated measures randomly
  controlled trial to compare two groups of
  pediatric TA patients. One group will receive
  Healing Touch post operative, while the control
  group will receive the usual standard of care.
• Research Questions
• 1. Does Healing Touch decrease stress in post
  operative pediatric patients ages 3-6?
• 2. Does Healing Touch decrease emergence
  delirium/ emergence agitation?
• 3. Does Healing Touch decrease the time it takes
  to meet discharge criteria?

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Next Steps

• Research evaluate outcomes
• Share outcomes
• Posters podium presentations
• Manuscripts
• Teach nurses Healing Touch to support their
  patients.
• Guide staff in Evidence-Based Practice
  initiatives at the unit level

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Bibliography

• Barnes PM, Powell-Griner E, McFann K, Nahin Rl.
  Complementary and alternative medicine use among
  adults United States, 2002. Adv Data. 2004
  3431-19.

• Hanley, M (2008) Therapeutic touch with preterm
  infants composing a treatment. Explore.
  July/August Vol. 4, No. 4 249-258.

• Im, H, Eunjung, K Effect of Yakson and Gentle
  Human Touch versus usual care on urine stress
  hormones and behaviors in preterm infants A
  quasi experimental study. International Journal
  of Nursing Studies 46 (2009) 450-458.

• Jain, S Mills, P (2010) Biofield Therapies
  Helpful or Full of Hype? A best evidence
  Synthesis. Int. J. Behav. Med. 171-16

• Kemper K, Flecher, N, Hamilton, C, McLean, T.
  (2009) The Impact of Healing Touch on Pediatric
  Oncology Outpatients Pilot Study. Journal of
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  (Winter),12-18

Kramer, N (1990) Comparison of Therapeutic Touch
and casual touch in stress reduction of
hospitalized children. Pediatric Nursing.
September-October Vol.16/no.5.483-485.

• Lee, MS, Pittler, MH, Ernst, E. (2008) Effects
  of Reike in clinical practice a systematic
  review of randomized clinical trials.
  International Journal of Clinical Practice Volume
  62, Issue 6, pages 947-954

• MacIntyre, B, Hamilton, J, Fricke, T, Ma, W
  Mehle, S Michel, M (2008). The efficacy of
  Healing Touch in coronary artery bypass surgery
  recovery A randomized clinical trial.
  Alternative Therapies Jul/Aug 2008. Vol 14. No 4

• Maville, J, Bowen, J, Benham, G. (2008) Holistic
  Nursing Practice, March/April103-110.

• So, PS, Jiang Y, Qin Y. Touch therapies for pain
  relief in adults. Cochrane Database of Systematic
  Reviews 2008. Issue 4. Art. No. CD006535. DOI
  10.1002//14651858. CD006535. pub2.

• Whitley, J, Rich, B. (2008) A double-blind
  randomized controlled pilot trial examining the
  safety and efficacy of Therapeutic Touch in
  premature infants. Advances in Neonatal Care,
  Vol.8, No.6 315-33