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Study Finds Multicolored Scrubs Brighten Pediatric Care

Keri Mucci, April 14, 2009

A hospital can be a frightening place for children, which in turn creates a barrier of distrust nurses must work through in order to provide them with adequate care. However, recently released research suggests nurses can do less scaring and more caring for their facility's pediatric patients by brightening up their wardrobe.

A study published in the April 2009 issue of the Journal of Clinical Nursing examining the effect of multicolored, nonconventional attire on hospitalized children found it improved children's and parents' perceptions of the nurses providing them care. These enhanced perceptions led to increased comfort for the pediatric patients and increased confidence among parents of the nurses' abilities.

"Our goal was to understand the perception of nurses," says Filippo Festini, BA, BSN, RN, lead author of the study and professor of nursing science at the University of Florence in Italy. "The importance of our findings is that the multicolored uniforms improve the relationship between the nurse and the child, and this helps obtain the child's compliance to the treatment and reduce anxiety and fear."

The study was conducted by Festini and his team of University of Florence researchers between July and September 2005 among children at Meyer Children's Hospital in Florence. The researchers surveyed 112 children—ranging from six to 16 years of age—before and after nurses on two pediatric hospital wards swapped their light blue, traditional scrub uniform for nonconventional attire inspired by children's drawings collected throughout the country (you can view a picture of both uniforms here).

In both instances, researchers asked the children to define the nurses using one word, discovering a higher percentage (96%) used positive words such as "pleasant," "friendly," and "helpful" for nurses wearing the new uniforms than when they wore the former (82%).

The study cites "the children also expected the nurses to be 'funny' and 'cheerful,' and to play with them" while wearing the new uniforms. Researchers concluded the children's perceptions regarding the hospital environment, however, did not improve.

While the nursing uniform has dramatically evolved over the past few decades, many nurses still shy away from those splashed with child-friendly prints for fear they detract from their professional image. Shelley Cohen, RN, BS, CEN, president of the Hohenwald, TN-based Health Resources Unlimited, LLC, recently conducted an anonymous, national survey among more than 1,000 nursing professionals to delve into the types of behaviors, attitudes, appearances, and circumstances they felt shaped their image. Respondents were asked to rate several factors based on how much they affected the image of nursing, choosing from "no effect," "little effect," or "great effect." How nurses present themselves to patients and families was reported to have the greatest effect on their image. How nurses' dress was found to have the fifth greatest effect.

Furthermore, respondents suggested individual nurses could shape a more realistic image of nursing by ridding cartoon scrubs from their wardrobe.

Still, peering back into the pediatric study, the multicolored scrubs did not worsen pediatric patients' and parents' perceptions of nurses' professionalism, yet seemed to improve it. For example, researchers asked parents to rate the nurses on a one-to-five scale. Of their findings, parents' perceptions of nurses':

  • Adequacy in their role increased from 4.0 to 4.7
  • Ability to be reassuring rose from 4.0 to 4.5
  • Ability to not frighten their child rose from 4.4 to 4.7
  • Ability to be fun improved from 2.3 to 4.6

"By wearing creative and child-friendly scrubs, nurses demonstrate respect for the patients they are caring for and send a message that they understand children and their developmental needs," says Jill Duncan, RN, MS, MPH, director of the IHI Open School for Health Professions in Cambridge, MA, who has more than 15 years of pediatric-related experience in a variety of acute care settings.

Duncan says nurses can even use their scrubs as a discussion starter with their young patients by pointing out drawings or characters and asking the child what he or she sees. "This helps engage the child as well as assure the parents that there is a confident and competent nurse caring for their child," she says.


Keri Mucci is an editorial assistant in the nursing market at HCPro, Inc. She edits the journal Strategies for Nurse Managers, maintains www.StrategiesforNurseManagers.com and www.StressedOutNurses.com, and writes articles and conducts market research within the industry. She can be reached at kmucci@hcpro.com.

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