Background

The Margaret Pyke Centre is an integrated sexual health service with up to 500 attendances a week and 200 procedures performed per month. The majority of the procedures carried out in the service are related to the provision of intrauterine contraception (IUC).

Anxiety has been shown to contribute to higher levels of pain perceived during procedures such as IUC insertion.1 Distraction during the procedure may help in reducing anxiety and consequently pain. For example, during IUC insertion, verbal distraction, popularly referred to as ‘verbal anaesthesia’ or ‘vocal local’, can be provided by an assistant, or the patient could be advised to hold a small warm water bottle or chemical warming pack inside a disposable cover to the suprapubic region.2

We thought of a different way of distracting patients during procedures. Patients had previously reported that static pictures on the ceilings in our clinic rooms were helpful. As a result of a charitable donation, in September 2013 the service installed televisions (TVs) in three clinic rooms where procedures such as IUC insertions are performed. The aim was to give patients the choice to watch and/or listen to something during their procedures. TVs are already successfully used during dental procedures and paediatric phlebotomy, but their use has not been reported during procedures in sexual health.

How did we go about the change?

The service was changing sites and the opportunity was used to install a TV on the ceiling, directly above the examination couch in the rooms (figure 1 …