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    Challenges in the Management of Pediatric Central Venous Access Devices in the Community.

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    Authors
    Wallace, Elaine
    Twomey, Marie
    O'Reilly, Maeve
    Affiliation
    Department of Palliative Medicine, Our Lady's Hospital for Sick Children , Crumlin, Dublin , Ireland.
    Issue Date
    2012-05-25
    
    Metadata
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    Citation
    Challenges in the Management of Pediatric Central Venous Access Devices in the Community. 2012:notPediatr Hematol Oncol
    Journal
    Pediatric hematology and oncology
    URI
    http://hdl.handle.net/10147/235111
    DOI
    10.3109/08880018.2012.684135
    PubMed ID
    22632142
    Abstract
    Central 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.
    Item Type
    Article
    ISSN
    1521-0669
    ae974a485f413a2113503eed53cd6c53
    10.3109/08880018.2012.684135
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