Challenges in the Management of Pediatric Central Venous Access Devices in the Community.
AffiliationDepartment of Palliative Medicine, Our Lady's Hospital for Sick Children , Crumlin, Dublin , Ireland.
MetadataShow full item record
CitationChallenges in the Management of Pediatric Central Venous Access Devices in the Community. 2012:notPediatr Hematol Oncol
JournalPediatric hematology and oncology
AbstractCentral venous access devices (CVADs) play an essential role in the care of critically ill children. Significant challenges exist for teams in managing CVADs particularly in a community setting. The authors aimed to assess the experience of general practitioners (GPs) caring for children with CVADs. From 200 CVADs inserted in a pediatric hospital in 2009, 50 patients were randomly selected and 44 GPs were forwarded a questionnaire. Twenty (46%) GPs responded. The main reasons (n = 22) for using CVADs were medication administration (n = 11), nutrition (n = 6), and blood sampling (n = 5). Thirteen (65%) GPs had no education in CVAD management and 14 (70%) were unaware of existing guidelines. Those identified by GPs as having primary responsibility for care of CVADs in the community included hospital/pediatric teams (n = 9), parents (n = 3), GPs (n = 2), public health nurses (n = 1), and palliative care ("home care") teams (n = 1). The main challenges (n = 15) identified by GPs were lack of education (n = 4), line management difficulties (n = 3), infection risk (n = 3), infrequent exposure to CVADs (n = 3), and poor communication (n = 1). GPs felt that these challenges could be addressed through: education (n = 8), increased manpower and community support (n = 1), and improved communication (n = 1). This study highlights the inconsistency and challenges for GPs surrounding CVAD use in children. Further education and support is necessary to assist GPs in their use particularly when providing end-of-life care for children in the community.
- Experience with central venous access devices (CVADs) in the Canadian hemophilia primary prophylaxis study (CHPS).
- Authors: Langley AR, Stain AM, Chan A, McLimont M, Chait S, Wu J, Poon MC, Card R, Israels SJ, Laferriere N, Klaassen RJ, Rivard GE, Cloutier S, Hawes S, Feldman B, Blanchette V
- Issue date: 2015 Jul
- Road map for improvement: Point prevalence audit and survey of central venous access devices in paediatric acute care.
- Authors: Ullman AJ, Cooke M, Kleidon T, Rickard CM
- Issue date: 2017 Feb
- Selection and management of central venous access devices in the home setting.
- Authors: Cole D
- Issue date: 1999 Nov-Dec
- Caring for children dying from cancer at home: a qualitative study of the experience of primary care practitioners.
- Authors: Neilson SJ, Kai J, Macarthur C, Greenfield SM
- Issue date: 2011 Oct
- Providing palliative care for cancer patients: the views and exposure of community general practitioners and district nurses in Japan.
- Authors: Yamagishi A, Morita T, Miyashita M, Ichikawa T, Akizuki N, Shirahige Y, Akiyama M, Eguchi K
- Issue date: 2012 Jan