The nursesвЂ™ approach centres on helping the children to: With children who are very fearful, it is essential that the child feels in control and this may mean taking the process very slowly. This usually involves home visits and working with the childвЂ™s parents, so that they can undertake the desensitisation work themselves. All classes in a school can usually been seen in a single day, however some children will still require more intensive desensitisation work and so one-to-one input is offered where needed. In these schools, it is usually enough to deliver structured group work annually, prior to the flu vaccinations. All members of the Care TrustвЂ™s school nursing team now deliver these sessions. In the more вЂgenericвЂ™ special schools, sessions are tailored to different levels of understanding.

The four-stage mantra helps the children get used to the process and repetition is fundamental to the success of this work. The nurses still use a story approach and visual images which act as a reminder of each of the four stages. When introducing older children to this programme, they use syringes to dribble water on the back of their hands and work on desensitising them in this way. One nurse is able to see 80-100 children in around two and a half hours. Initially, working with every child in the school was time-consuming but the Care Trust now has an established routine, so they only need a brief amount of time with most children. They found that 5ml syringes were the best to use - small enough not to intimidate and strong enough to endure mouthing, if a child inadvertently holds one. To end the rhyme, instead of saying вЂtickle you under thereвЂ™ they say вЂinjection over thereвЂ™ and touch the childвЂ™s arm at the injection site. When they take the вЂone stepвЂ™, they touch the child inside the elbow to help prepare them for accepting blood tests. They start doing this whilst just holding a syringe in their hand and using their fingers, then progress to using the syringe to touch the back of the childвЂ™s hand. With very young children, the specialist nurses use the nursey rhyme вЂround and round the gardenвЂ™ as an approach to support immunisation. A very small number of children cannot tolerate the verbal approach, so are simply shown the images. This is supported with visual images, using Boardmaker software, and is repeated verbally to the children at each step. They start this work with children as soon as they begin in reception year and they use a вЂ4-stage mantraвЂ™ to support the childrenвЂ™s learning: This work has only been possible because the school have been very supportive of the Care TrustвЂ™s input. She has designed and delivered sessions on immunisation preparation, to better support children with learning disabilities in Bradford.ДЄt one school for children with profound autism she designed a large-scale desensitisation programme, delivered on a weekly basis. Tina Wildy is a nurse specialist at Bradford District Care NHS Foundation Trust, and supports children with learning disabilities and autism in schools. Care TrustвЂ™s work in schools in Bradford, West Yorkshire Whilst most of the examples we were sent about desensitisation describe work done with individuals we have also been told about a large-scale desensitisation programme. She had her favourite music whilst this was happening.ДЇor further information please contact Hayley Goodwin. We then supported her when she went for a blood test and gave the massage before the blood was taken. The 3rd week we started to tighten the band very slightly and gave the massage. After the first two visits, we introduced the elastic band and placed this on the arm (without tightening it) and continued with the massage. We played her favourite music and she got used to the person giving the massage. By offering massage you can build a rapport and trust. We visited the community client twice a week for 4 weeks prior to the blood test and gave a massage to the arm (this increased the blood flow to the arm). This example of desensitisation was sent to us by an occupational therapist who worked jointly with a nursing colleague: Desensitisation work Central and North West London NHS Foundation Trust Below are some of the examples we were sent. The majority of these were stories which described desensitisation work as well as reasonable adjustments that were put in place for the individual. We had a lot of responses to our information request for examples of good practice in relation to blood tests and injections for people with learning disabilities.

Pclp for needle desensitisation