Waiting and changing room facilities for children
1. In order to make children feel comfortable whilst waiting for an investigation or treatment, you should provide a separate waiting area for families or at the very least a partitioned section which provides a friendly, bright, reassuring and welcoming environment. Studies have shown that the quality of the waiting environment influences perception of quality of care and caregivers and is significantly associated with reduced anxiety (1). You might wish to consider the use of sturdy shelved bookcases to act as a partition(s) and as a repository for children’s books and worksheets etc.
2. Changing facilities must provide sufficient space for children and parents with gowns in a range of different sizes. Children shall be treated with tact and understanding and their privacy shall be respected at all times (Art 10 of the EACH Charter).
3. Toilet facilities should be in an accessible location with lightweight doors that are easy to open with toilets and washbasins of a suitable height and with facilities for mothers to change babies. Mothers should not have to use toilets for breast feeding; identify an area where this activity could be conducted in private. Facilities for hand hygiene e.g. waterless hand hygiene products or sinks with soap and disposable towels should be available in the waiting room.
4. If you plan to put posters or pictures on the waiting area wall, it seems from surveys that children of age range 5-17 yrs, when in hospital settings, prefer representational nature art over abstract art (2) and not, as might be imagined large cartoon-like or fantasy images. They apparently rate nature images with bright colours, water features and non-threatening wildlife quite highly, often higher than typical ‘child’ art (3).
5. What you provide for children as ways to pass the time will send a powerful message about what you see as fun and worthwhile. So ensure the availability of appropriate play equipment suitable for a wide range of ages and ability, which do not increase the risk of spread of infection, and which are safe, durable and versatile.
6. Play tables and wall mounted play panels are preferable and an alternative to a miscellaneous box of toys/games.
See websites for the types and range as examples of what is available:
http://www.gltc.co.uk/play-tables/dept/fcp-category/list or
http://www.kiddinaround.com/pages/Information-about-Pediatric-Waiting-Rooms.html
or http://www.sensoryedge.com/ or http://www.ronjuneshop.com/
7. If using toys/games choose those with smooth surfaces that can easily be cleaned daily or if soiled and avoid toys with small pieces, crevices, stuffed toys and toys made of fabric (4). Toys/ games should be stored in a dedicated cupboard/ box (or play area if large) fit for purpose and is the subject of an identified and documented regular cleaning schedule.
8. Consider the use of disposable books or toys or paper sheets designed for individual use. Provide stacks of photocopied single sheets activities to suit a range of children- worksheets, Sudoku, word games, colouring-in sheets/pictures etc. Crayons should be provided for children and parents to keep and take away (think Italian restaurants) –thus avoiding having to ensure their cleanliness for others to use.
9. Provide a notice asking parents to supervise the use of waiting room toys by young children, not to permit toy sharing and to place toys in a designated USED toy container. Older children who are mature enough to have appropriate hygienic practices ( e.g. hand hygiene and handkerchief use) may share toys, books, computer games etc. (5).
10. Most hospitals will have a ‘Toy Cleaning Policy’ you must ensure that you have read it and followed its requirements. Managers should not purchase nor accept donations of brand new toys/games unless they conform to BS standard and there is an approved method in place for the cleaning of particular items; in addition managers must ensure that they have a written system in place which is in line with any hospital/trust policy, for the cleaning of toys/games/equipment. Previously owned and used toys/ games by the general public should not be accepted because the cleanliness or safety of these items cannot be assured.
References & Bibliography
(1) Arneill, A. B., & Devlin, A. S. (2002). Perceived quality of care: The influence of the waiting room environment. Journal of Environmental Psychology, 22(4), 345-360
(2) Eisen S (2005) Artfully designed paediatric environments Unpublished doctororal dissertation Texus A & M University
(3) Nanda U et al (2009) Pediatric Art Preferences in Healthcare:countering the “one –size fits all” approach Health Environment Research and Design Journal, 2(4), 44-48
(4) Pati D. (2009) Influence of positive distractions on children in hospital waiting areas Dallas:HKS Inc
(5) Moore D.L. (2008) Infection control in paediatric office settings Paediatr Child Health 13(5), 422-435
EACH charter
http://www.each-for-sick-children.org/each-charter/the-10-articles-of-the-each-charter.html
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