Improving Peripheral Intravenous Catheter Care for Children with Cancer Receiving Chemotherapy in Malawi

Abstract

To change pediatric oncology nursing management of peripheral intravenous catheter (PIVC) insertion and care based on current best evidence. Design and methods: Practice change strategies were developed, and nurses completed education on proper PIVC insertion, dressing placement, and ongoing PIVC assessment with emphasis on preventing chemotherapy extravasation. Nurses also completed a chemotherapy course as part of their orientation program. The plan for PIVC practice change was based on evidence from published research and established PIVC care guidelines. Preassessment data revealed numerous PIVC attempts and a high incidence of extravasation (42%) in children with cancer receiving treatment in Malawi. Results: Post-assessment data nine months later resulted in a reduced extravasation rate from 42% to 4% using point prevalence assessments. PIVC insertion attempts reduced following education and guideline implementation; 81% of children required more than 3 PIVC insertion attempts before the practice change. Only 1% of PIVC insertions required more than 3 attempts after education and practice change implementation. Nurses completed a 32-item written examination before the chemotherapy course; the mean score was 50/100. Upon completion of the chemotherapy course, nurses obtained a mean score of 97/100 on the written examination. Conclusions: Using an organized approach to nursing practice change improved PIVC care in children with cancer.Practice implications: This project provides evidence that nursing practice change strategies can be used in any setting including countries like Malawi with limited resources.

Mothers’ knowledge regarding peripheral intravenous catheter caring and complications among pediatric patients: A cross-sectional study

“…It seems that mothers who are admitted with their children to the hospital are taken into consideration the complications of PIVC regarding signs and symptoms such as pain, redness, tenderness, extravasation, warmth, erythema, and swelling. This result is consistent with previous studies of Mulemba et al [19] and Suliman et al [20] Indeed, an insertion of PIVC in pediatric patients leading to difficult experiences, pain, and fear is evident. We observed in this study that mothers are aware to choose the proper site of PIVC, pick the proper type of cannula, select the type of duoderm, wash their hands after using and caring for PIVC.…”

O gerenciamento do cuidado da enfermagem pediátrica no contexto quimioterápico

“…O desenvolvimento de programas de educação e capacitação dos profissionais tem como objetivo oferecer um atendimento de qualidade para os pacientes, pois estes estão atrelados a um ambiente de trabalho saudável e com isso a uma maior satisfação da equipe de enfermagem, promove gerentes com liderança transformacional e habilidades para apoiar a sua equipe e reconhecer a qualidade do seu trabalho. (17) De igual modo, ela contribui para uma maior segurança da equipe de enfermagem ao prestar os cuidados à criança, pois evita erros e eventos adversos durante a assistência, promovendo a qualificação e atualização dos profissionais frente a novas técnicas, protocolos e administração de medicamentos. (14,(18)(19) A qualificação e experiência profissional são aspectos importantes para a atuação do enfermeiro em oncologia, pois são exigidos conhecimentos específicos, habilidades e comportamentos para atuação com qualidade e segurança.…”

Healthcare-associated infections in patients who are immunosuppressed due to chemotherapy treatment: a narrative review

“…and Trichosporon asahii) or viruses (herpes simplex and herpes zoster) are usually related to skin infections, and only 5-10% of those are characterized as polymicrobial infections [19,22,33]. In order to prevent possible infectious proliferations, some catheters are impregnated with antimicrobial or antibiotic substances [22,34,35]. Previous studies do not correlate gender or age with the occurrence of skin infections in cancer patients, but to the introduction of some device or to surgical site infections.…”