{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:53:11Z","timestamp":1791269591419,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Children experience procedural trauma from medical interventions that may cause harm. Yet, healthcare workers report limited access to relevant training. CALM Care (Comfort, Analgesia, Language, Mindfulness, Memory) is a trauma\u2010informed model and training approach for universal best\u2010practice procedural care.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n (1) Examine how CALM Care is implemented in real\u2010world settings, (2) generate knowledge about how multi\u2010modal implementation strategies influence uptake, (3) pilot measures of clinical effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Mixed\u2010methods implementation evaluation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n CALM Care was implemented across eight departments (~480 staff) within a metropolitan paediatric teaching hospital between October 2024 and June 2025, guided by the integrated Promoting Action of Research Implementation in Health Services framework. Implementation strategies (e.g., facilitation) were informed by programme theory. Structured observations (\n N<\/jats:italic>\n \u2009=\u200963) of children (mean age 2\u2009years, 7\u2009months) undergoing needling was used to assess fidelity, acceptability and clinical outcomes. Organisational metadata informed adoption and feasibility. Data was analysed using a deductive\u2010inductive hybrid thematic approach.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seven departments participated. Following implementation, CALM Care principles (except Comfort) were adopted (i.e., >\u200920% increased use in standard care). Up to 80% of targeted staff (\n n<\/jats:italic>\n \u2009=\u2009360) completed training. Documentation of procedural plans increased six\u2010fold. First\u2010attempt proceduralist success improved >\u200910%, although pain scores did not clinically change significantly. Acceptability to staff and consumer satisfaction was high. Fidelity was strongest for Language (95%), Mindfulness (95%) and Analgesia (85%). Key enablers were adaptability of CALM Care operationalisation, leadership engagement and integration of context\u2010specific resources and workflows.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Theoretically informed strategies support adoption of trauma\u2010minimising practices. However, sustained leadership and policy support are essential to maintain cultural change.<\/jats:p>\n <\/jats:sec>\n \n Implications for Profession and\/or Patient Care<\/jats:title>\n Organisational adoption of CALM Care may enable delivery of least\u2010restrictive care to reduce medical trauma in paediatric hospital settings.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n The evaluation followed the StaRI and TIDieR checklists.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n No Patient or Public Contribution: Patients or members of the public were not involved in the design, conduct, reporting, or dissemination plans of this research, which has been acknowledged as a limitation of this study.<\/jats:p>\n <\/jats:sec>\n \n Global Contribution<\/jats:title>\n \n Dynamic facilitation that builds workforce confidence in procedural care may shape a child's lifelong engagement with healthcare. CALM Care,\n every time,<\/jats:italic>\n matters.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70741","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:31:33Z","timestamp":1791268293000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation Evaluation of\n CALM<\/scp>\n Care: Examining a Universal Procedural Care Approach for Healthcare Workers in a Tertiary Paediatric Hospital Setting"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8993-5202","authenticated-orcid":false,"given":"Megan","family":"Simons","sequence":"first","affiliation":[{"name":"Occupational Therapy Department, Queensland Children's Hospital Children's Health Queensland Hospital and Health Service Brisbane Queensland Australia"},{"name":"Child Health Research Centre The University of Queensland Brisbane Queensland 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5599-2952","authenticated-orcid":false,"given":"Ellen","family":"Curtis","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences The University of Queensland St Lucia Queensland Australia"},{"name":"Occupational Therapy Department Toowoomba General Hospital Toowoomba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2455-8063","authenticated-orcid":false,"given":"Fiona","family":"Macfarlane","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Anaesthesia, Queensland Children's Hospital Children's Health Queensland Hospital and Health Service Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2651-7103","authenticated-orcid":false,"given":"Anna","family":"Young","sequence":"additional","affiliation":[{"name":"Occupational Therapy Department, Queensland Children's Hospital Children's Health Queensland Hospital and Health Service Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010025\u201002941\u20102"},{"key":"e_1_2_14_3_1","volume-title":"National Safety and Quality Health Service Standards","author":"Australian Commission on Safety and Quality in Health 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