Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Christina Cavinder


Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that incorporates cryotherapy and vibration was selected and used during vaccinations in children ages newborn to seven years of age. The Johns Hopkins Nursing Evidence Based Practice Model was selected as a guide for the EBP project development, planning, and implementation at an outpatient family practice office in Northern Indiana. The nursing staff performed vaccinations using standard of care for pain for four weeks, then the implementation of Buzzy® was used for four weeks. Data were collected using two pain rating scales associated with specific ages. The Face Legs Activity Cry Consolability Scale (FLACC) was used to observe the pain behavior of children ages newborn to two years. The Wong- Baker FACES Pain Rating Scale was used for children ages three to seven years. Data were collected through electronic medical record and then analyzed through chi-square for demographic information and chi-square for independence for outcomes on pain. The demographic differences between the two groups were statistically insignificant. The FLACC outcome scores were significantly different between the pre- and post-intervention groups (x2(4, N=28) = 12.48, p < 0.05) while the FACES outcome scores were insignificant (x2(3, N=28) = 5.94, p > 0.05). The results showed that future research for pain management strategies during needle-based procedures is still essential for improving patient comfort, as well as improved patient compliance.

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Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

M. Byma DNP Poster.pdf (203 kB)