Date of Award


Document Type


First Advisor

Kristen Slabaugh


Background: Routine vaccination is an important component of pediatric preventative care but for many children, the experience can be painful and anxiety provoking, potentially leading to a cascade of negative events. Problem: Under-recognition of the pain that children experience during vaccination leads to an under management of such pain in ambulatory care settings. Methods: The Face, Activity, Legs, Cry, Consolability (FLACC) scores of a convenience sample of children ages 2 months to 7 years at a small, rural family practice clinic were evaluated throughout the vaccination process over a three-month time period. Intervention: Two evidence-based interventions - distraction techniques and comfort positioning, including breastfeeding - were implemented by clinicians in an attempt to decrease the patients’ pain perceived during the vaccination procedure. FLACC scores were evaluated one minute before vaccination, during vaccination, and one minute after to investigate the effectiveness of such interventions. Results: Statistical analysis of pre-intervention difference scores compared with those observed during the intervention period demonstrate a beneficial relationship between the use of distraction and comfort positioning and a decrease in pediatric pain experience. Conclusion: The use of evidence-based distraction techniques and comfort positioning offers an easily implemented, cost-effective solution to the problem of under managed pediatric procedural pain.