Document Type

DNP Project

Publication Date

2025

Degree Name

Doctor of Nursing Practice

Faculty Advisor

Sue Penque PhD, APRN, ANP-BC, NE-BC, NC-C

Practice Mentor

Carolyn Levy, DNP, APRN, CPNP-PC, IBCLC

Abstract

Background

Many children experience discomfort when receiving routine vaccines via IM injections. The thought of this discomfort can lead to anxiety for the children when visiting their primary care providers. The use of vapocoolant spray prior to IM vaccine administration can help decrease pain/discomfort experienced by children, resulting in increased patient and parent satisfaction.

Project Goals

  1. Develop an educational packet reviewing use of topical anesthetics in pediatrics
  2. Staff will use vapocoolant spray prior to vaccine administration
  3. Children will experience less pain during vaccine administration and parents will feel more satisfied with their child's experience

Methods

Education on the use of vapocoolant spray was provided to the office nursing/medical assistant staff. Staff offered vapocoolant spray to children 4 years of age and older when receiving IM vaccine administration. Vapocoolant spray was applied to children whose parents consented. The child’s discomfort was assessed immediately after vaccine administration using the FACES pain scale (Appendix H). Parents were asked if they felt this vaccine experience was better than previous experiences not using a topical anesthetic. Data was collected from 9/16/2024-11/14/2024.

Results

100% of the staff completed the brief education presentation and post-survey on vapocoolant spray. 100% of the staff scored ≥80% on the post-test prior to the initiation of the project. A total of 160 participants had the vapocoolant spray applied to their deltoid prior to receiving IM vaccines. The patients' ages ranged from 4-years-old to 19-years-old. Overall, 89% of parents were satisfied with the vapocoolant spray. 93% of participants rated their pain ≤4 on the FACES scale. On average, the whole application, pain evaluation, and post-question for the parents only added 2 minutes to the staff’s standard vaccine administration procedure.

Conclusion

The use of vapocoolant spray prior to IM vaccine administration decreased pain experienced for 93% of the participants. 89% of parents were satisfied with the experience of using a vapocoolant spray prior to IM vaccine administration. The practice change should be implemented as it proved to have very positive outcomes for patients and parents, and did not add much time or strain to the staff’s workload.

Comments

A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Available for download on Wednesday, April 08, 2026


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