A unique, nurse-led approach
The UZ Leuven prosa team is nurse-led, which meants that nurses take the lead in the day-to-day supervision of children. In 2014, that was a first for Belgium, but still remains unique ten years on. Lies Cremers, coordinator of the prosa team and responsible for pain management in the children's hospital, explains.
“The prosateam was created in 2014 at the initiative of dr. Marleen Renard and prof. Karel Allegaert, with the aim of avoiding the use of coercion in children and better supporting them in anxiety and pain. To make this possible, a number of nurses took a course to build up the necessary expertise in helping children. Moreover, they were given the room to personally support children during their treatment - room that was often lacking on the ward itself. This created a structural, child-friendly approach for pain and anxiety, unique in Belgium.”
Positive communication and trust as core values
The team currently consists of six specialised nurses, who in addition to their jobs in wards such as A&E and obstetrics, work part time for prosa. Every day, one of them is on hand to look after children and answers any questions or concerns parents might have. Lies: “With our mobile, elektric cart full of tools we can provide quick and targeted support throughout the entire hospital. In the process we work closely together with paediatricians, anaesthesiologists and psychologists.”
One of the team's greatest strengths is their personal and positive approach, says Lies: “We want to support and prepare the children in such a way that they feel like they can do it, and that they will succeed, with or without pharmalogical aids. Trust plays a crucial part, and we try to build some sort of connection with every patient." In addition to to nitrous oxide and narcotic creams, the team also focuses on positive communication and techniques to give young patients a sense of control over the situation. “The way we say things makes a big difference. For instance, if we say 'you're not allowed to move" during a scan, they actually often do move. But if we say ‘you're doing a great job of lying still’, they are often much calmer,” Lies explains.
Stronger together
There is a warm relationship with the Dutch prosa faculty that provides training courses and symposiums. ‘Following their example, we set up a prosa faculty in Flanders last year to share expertise and spread knowledge further,’ Lies says. ‘However much we differ from other hospitals, we all bump into the same challenges. It helps if you can then coordinate with other teams, especially for unique or rare cases.'
High-impact tailored care
In 2020 the prosa team provided support for 1,129 young patients. In 2023 this number went up to 1,501. And this increase continues. 'We've noticed that the demand for customised help for children increases, whether it is fear of needle pricks or a scan that you have to lie still for', says Lies. 'It is important to handle this in a professional manner. Research shows that the additional social cost of children developing distrust in care and therefore avoiding care is greater than the cost of addressing such issues in time through initiatives such as our prosa team. A thoughtfully tailored approach increases the likelihood that young patients will have a positive experience in hospital, allowing them to be more confident towards care later on.'
The 10-year anniversary is not only a milestone for the prosa team, it also clearly underlines the value of warm and personal care. Lies: ‘Every day, our team remains committed with one clear objective: every child deserves to have their pain and anxiety taken seriously. Or as paediatric intensivist Piet Leroy so eloquently puts it: "comfort and trust on the part of the child are as important as the medical procedure itself".'
Want to find out more about what UZ Leuven does to help children with pain or anxiety?