6 Changes to Help Kids (And Adults) with Autism Prepare for Surgery

For kids with sensory issues or the inability to communicate their needs, the bright lights, unfamiliar noises, and basic care in the pre-op setting can be traumatizing.

As the mother of a child with autism, Shelly Reyes, BSN, RN, CPN, was painfully aware of these common stressors in her perioperative setting at Valley Children’s Healthcare in Madera, CA. She knew there was a better way to help kids with special needs prepare for surgery. So, Reyes partnered with a multidisciplinary team of nurses, physicians, and child life and behavior specialists to create the George’s Pass program — a specialized approach to get kids ready for surgery.

“George's Pass forms an allyship with parents, so we can provide an individualized experience for children with autism and special needs,” Reyes explained during her poster presentation at AORN’s annual conference last month. Her poster earned top honors at AORN in the category for Diversity, Equity, and Inclusion (DEI).

Reyes’ efforts have also positively impacted the kids she cares for and made a difference in her community. Recently, George’s Pass was adapted for use at a local zoo and an annual 5K community event.

6 Changes to a Better Surgical Experience for Kids with Special Needs

Reyes walked us through key elements of George’s Pass that she says any team can adapt in their own pre-op setting:

1. Prepare patients and families ahead of time with both an intake form for specific needs and a tour with step-by-step guidance on what to expect the day of surgery.
2. Reduce exposure to busy waiting areas by directing patients and families to a private room upon arrival, where lights are dimmed and monitor volume is turned down.
3. Have a toolbox for sensory regulation and distraction at the ready with toys such as bubbles, a holographic vein finder, and noise-cancelling headphones.
4. Put patients in the driver’s seat to surgery by replacing the gurney with a remote-controlled car they can ride in to help reduce anxiety with parent separation.
5. Allow parents to be present at induction to reduce anxiety and the need for sedation.
6. Create a quiet recovery experience in a private room with dimmed lights and reduced sounds.

Implementation Tip: Focus on Staff Education

Reyes and her team provided educational workshops, annual education, and specialized training detailing autism spectrum disorders, how the hospital experience affects these patients, and what perioperative professionals can do to help. “Understanding the ‘why’ behind how we can better care for these kids gave all of us an opportunity to improve care and give every child our best,” Reyes said.

And, the data she shared proved it. She found a 175% increase in staff comfort level caring for kids with autism and other special needs after implementing George’s Pass.

Reyes said her poster being recognized by AORN for DEI was such an honor as to what George's Pass represents for ALL people with autism. “It's a testament to the work we do and the promise we make to provide the best care for every single child who enters our hospital. Knowing our families are depending on us to be the place where their child will be understood, cared for, and supported is such a wonderful purpose that we are proud to serve.” She noted that some elements of George’s Pass such as reducing lights and noises could also be beneficial for adults with autism.

Learn more about the work of Reyes and her team to create George’s Pass with your AORN Expo Virtual Pass.