Balancing technology and nursing care in paediatric practice – Registered Nurses' experiences of XR distraction being used during needle-related procedures

INTRODUCTION: For nurses in paediatric practice, needle-related procedures might pose challenges, and they may experience uncertainty regarding the child's best interests, particularly when considering whether to use coercion. For children, needle-related procedures often cause anxiety and distress. Distraction techniques, such as eXtended reality (XR), have been shown to reduce procedural pain and anxiety. This study aimed to explore registered nurses' experiences when children used XR distraction during needle-related procedures. METHODS: A convergent parallel mixed-methods design was employed. Descriptive statistics were applied to the survey data, while reflexive thematic analysis was conducted to identify patterns within the qualitative data. Quantitative and qualitative data were analysed separately and subsequently integrated for joint discussion and conclusions. RESULTS: In total, 20 individual nurses participated, resulting in 26 self-reported surveys and 23 interviews. Observed pain scores for both groups of children were recorded using an NRS scale from 0 to 10 (VR = 1.1; AR = 0.9). High levels of staff satisfaction were also reported regarding recommending XR distraction to other patients (VR = 100%; AR = 100%). Two principal themes were generated from the qualitative data. An altered work situation described experiences of modified interactions and a shift towards procedure-centred care. A favourable situation for children described XR distraction as a positive addition to paediatric practice. CONCLUSION: Nurses identified both opportunities and challenges associated with integrating XR distraction into paediatric practice. To ensure successful and sustainable implementation of these technologies, it is essential to balance technological effectiveness with the presence and engagement of nurses.