Pain and anxiety can leave lasting impressions on pediatric patients, affecting future interactions with healthcare providers long after discharge. To address this, Kaiser Permanente Roseville’s Inpatient Pediatrics and Pediatric ICU teams launched the Distraction Cart in November 2025. This nurse-driven, evidence-based practice (EBP) project began after Pediatric ICU Clinical Nurse Dana Burke, MSHI, BSN, RN, CCRN completed an EBP immersion course through Kaiser Permanente’s Nurse Scholars Academy and UCSF.

Over six months, she learned the seven steps of EBP: cultivating inquiry, forming a Patient/Population, Intervention, Comparison, Outcome question, conducting a literature search, appraising evidence, integrating findings with clinical expertise and patient preferences, evaluating outcomes, and disseminating results. The literature review was extensive — over 1,800 articles were screened, 123 reviewed, 58 summarized, and 53 synthesized — to identify distraction techniques proven to reduce pain and anxiety. Collaborating with Child Life Specialists Traci Aoki-Tan and Kelsey Cramer, the team finalized the cart’s contents, developed nursing education, and planned logistics.

They trained 30 clinical nurses and 12 assistant nurse managers on distraction basics, cart use, and evaluation. Post-implementation surveys will capture details such as timing, techniques used, procedures performed, and feedback from patients, caregivers, and nurses on effectiveness. While Child Life Specialists remain a primary resource, the Distraction Cart ensures nurses have tools and training to provide comfort when specialists are unavailable — delivering compassionate, evidence-based care that truly makes a difference for Roseville’s youngest patients.