Reducing Fear Before Surgery: DNP student publishes research on Virtual Reality to improve pediatric experience

For pediatric patients, the moments before surgery can be some of the most stressful. Pediatric preoperative anxiety affects an estimated 50% to 75% of children and is linked to higher healthcare costs and more complex recoveries, emphasizing the need for effective, non-pharmacologic interventions.

Doctor of Nursing Practice (DNP) Nurse Anesthesiology student Francis Quartey at the College of Nursing is working to change that through research aimed at reducing perioperative anxiety. He recently published his work, “Use of virtual reality in reducing pediatric perioperative anxiety: A literature synthesis review for current evidence-based practice,” in the Journal of Nursing Education and Practice.

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The project was inspired by his clinical experience as a nurse anesthesia resident, where he observed how preoperative anxiety affects both children and their families.

“Anxiety in children is linked to difficult inductions, increased postoperative pain, maladaptive behavioral changes, and longer recovery,” Quartey said. “I wanted to find evidence-based interventions that could improve the perioperative experience without raising medication exposure.”

To better understand emerging solutions, Quartey examined how immersive technologies such as virtual reality (VR) compare with traditional methods and evaluated their feasibility for clinical use. Using PRISMA and JHNEBP methodology, Quartey analyzed 30 high-quality studies, including randomized controlled trials, systematic reviews, and meta-analyses. The review focused on pediatric patients aged 3 to 18 and sourced data from major databases.

His findings show that immersive VR lowers preoperative anxiety, enhances cooperation during anesthesia induction, and reduces the need for sedative medications. Studies also observed decreases in physiological stress markers, such as heart rate and cortisol levels, along with increased patient and family satisfaction.

The study presents VR as a safe, non-drug alternative to medications like Midazolam, which can pose risks such as delayed recovery and negative behavioral effects. “Immersive VR supports patient-centered care while minimizing unnecessary medication exposure,” Quartey said.

Beyond its clinical implications, the study highlights a gap between research and practice. Although evidence supporting VR continues to grow, adoption remains limited due to cost, provider familiarity, and workflow integration.

Quartey’s review also identified strategies to support implementation, including provider education, institutional backing, and integration into existing care protocols.

“One of the most important roles of doctoral education is turning strong evidence into real-world impact,” said Brian Ahn, PhD, dean of the College of Nursing. “This work is a clear example of how our students are helping close that gap in meaningful ways.”

“Francis’s work is a strong example of how evidence synthesis can directly inform clinical practice,” said Kristie Hoch, DNP, CRNA, MS, FAANA, program administrator of the DNP Nurse Anesthesiology program. “By translating complex research into actionable insights, this project helps bring innovative interventions like VR closer to everyday use in pediatric care.”

Along with Hoch, the project was completed under the mentorship of Christopher Herring, DNP, CRNA, and Luc Corriveau, DNP, MBA, CRNA, faculty members in the college’s Nurse Anesthesia program.

Quartey hopes his research will promote wider clinical adoption by providing a clear, evidence-based foundation for implementation. “I see this work supporting anesthesia providers and perioperative teams in integrating VR into practice, as well as encouraging future research on cost-effectiveness and long-term outcomes,” he said.

Throughout the process, Quartey improved his skills in evidence appraisal, scientific writing, and collaboration, while also enhancing his ability to translate research into practice.

“The publication of the study marks not only the culmination of my DNP project but also reflects the mentorship and academic rigor of the College of Nursing,” Quartey said. “I hope this work helps improve the perioperative experience for pediatric patients and encourages ongoing innovation in advanced nursing practice.”

After graduating in May, Quartey plans to practice as a Certified Registered Nurse Anesthetist (CRNA) while staying involved in evidence-based practice, quality improvement, and research. His long-term goals include advancing perioperative innovation and contributing to anesthesia education.