减少小儿肿瘤患者在家庭环境中获得的中心线相关血流感染[公式:见文本]。

IF 1.9 3区 医学 Q2 NURSING Journal of Pediatric Oncology Nursing Pub Date : 2020-05-01 Epub Date: 2020-02-26 DOI:10.1177/1043454220907551
Diane Altounji, Rachel McClanahan, Roxanne O'Brien, Paula Murray
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引用次数: 7

摘要

大多数接受癌症治疗的儿童需要中心静脉导管(CVC),这使他们面临中心静脉相关血流感染(CLABSI)的风险。当患者出院回家时,CVC已经到位,护理人员希望在他们第一次出院回家之前进行院内教育课程后保持CVC。在回顾文献后,教育过程被修改以提高照顾者的教育质量。在审查了现有的分步手册并认为符合最佳实践的同时,本项目还增加了其他材料:护理人员技能能力清单,一份关于家庭口腔护理和卫生的讲义,以及一份关于护士在诊断时向家庭提供哪些材料的指南。此外,护理人员被要求在随后的住院期间接受两次额外的CVC护理强化课程,其中包括使用能力清单重新展示技能。比较干预前后两组家庭获得性CLABSI,并测量强化教育的依从性。虽然没有发现统计学意义,但发现粘膜屏障损伤的干预前组发生CLABSI的几率更高(优势比= 2.23;95%可信区间[0.43,22.10])和实验室确诊的血液感染(优势比= 4.53;95%置信区间[0.59,203.71])。减少家庭获得性CLABSI的临床意义通过降低发病率和死亡率、住院时间和总体卫生保健成本对患者结局产生积极影响。
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Decreasing Central Line-Associated Bloodstream Infections Acquired in the Home Setting Among Pediatric Oncology Patients [Formula: see text].

Most children receiving cancer treatment require a central venous catheter (CVC), putting them at risk for central line-associated bloodstream infections (CLABSI). As patients are discharged home with a CVC in place, caregivers are expected to maintain the CVC following an in-hospital education session before their first discharge home. Following a review of the literature, the education process was modified to improve the quality of education for caregivers. While the existing step-by-step handbook was reviewed and deemed aligned with best practices, other materials were added for this project: a caregiver skills competency checklist, a handout reviewing oral care and hygiene in the home, and a guide for nurses on what materials to provide families at the time of diagnosis. Additionally, caregivers were required to receive two additional CVC care reinforcement sessions during subsequent admissions to the inpatient units, which involved redemonstrations of skills using the competency checklist. Home-acquired CLABSI in pre- and postintervention groups were compared, and compliance of reinforcement education was measured. Though no statistical significance was found, the odds of experiencing a CLABSI were found to be higher in the preintervention group for mucosal-barrier injury (odds ratio = 2.23; 95% confidence interval [0.43, 22.10]) and laboratory-confirmed bloodstream infections (odds ratio = 4.53; 95% confidence interval [0.59, 203.71]). The clinical significance of reducing home-acquired CLABSI has a positive impact on patient outcomes by decreasing morbidity and mortality, inpatient lengths of stay, and overall health care costs.

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: SPECIAL PATIENTS NEED SPECIAL NURSES Caring for children with cancer is one of the most technically and emotionally difficult areas in nursing. Not only are you dealing with children and adolescents who hurt, you must reassure and educate families, balance a multitude of other health care professionals, and keep up with ever-changing nursing practice and care. To help special nurses stay aware of the newest effective nursing practices, innovative therapeutic approaches, significant information trends, and most practical research in hematology and pediatric oncology nursing, you need the Journal of Pediatric Oncology Nursing. The journal offers pediatric hematology, oncology, and immunology nurses in clinical practice and research, pediatric social workers, epidemiologists, clinical psychologists, child life specialists and nursing educators the latest peer-reviewed original research and definitive reviews on the whole spectrum of nursing care of childhood cancers, including leukemias, solid tumors and lymphomas, and hematologic disorders. JOPON covers the entire disease process--diagnosis, treatment, recovery, and survival, as well as end-of-life care. Six times a year, the Journal of Pediatric Oncology Nursing introduces new and useful nursing care practice and research from around the world that saves you time and effort. Just some of the spirited topics covered include: Cancer survivorship including later-life effects of childhood cancer, including fertility, cardiac insufficiency, and pulmonary fibrosis Combination therapies Hematologic and immunologic topics Holistic, family-centered supportive care Improvement of quality of life for children and adolescents with cancer Management of side effects from surgery, chemotherapy, and radiation Management of specific symptoms/diseases/co-infections Medication tolerance differences in children and adolescents Pain control Palliative and end of life care issues Pharmacologic agents for pediatrics/clinical trial results Psychological support for the patient, siblings, and families The dynamic articles cover a wide range of specific nursing concerns, including: Advanced practice issues Clinical issues Clinical proficiency Conducting qualitative and quantitative research Developing a core curriculum for pediatric hematology/oncology nursing Encouraging active patient participation Ethical issues Evaluating outcomes Professional development Stress management and handling your own emotions Other important features include Guest Editorials from experts in the discipline, Point/Counterpoint debates, Roadmaps (personal insights into the nursing experience), and Proceedings and Abstracts from the annual Association for Pediatric Hematology/Oncology Nurses (APHON) conference. Your special patients need special nurses--stay special by subscribing to the Journal of Pediatric Oncology Nursing today! This journal is a member of the Committee on Publication Ethics (COPE).
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