HOW DO YOU INSERT, MANAGE AND REMOVE CVADS IN YOUR PEDIATRIC CANCER CARE PRACTICE?

As a vascular access community, we strive to promote central venous access device (CVAD) performance and prevent adverse events, such as infections and blood clots. This involves carefully selecting and inserting the appropriate type of device, effectively managing it, and monitoring for potential complications. [1]

In pediatrics, almost all children receiving treatment for cancer require a CVAD during their treatment.

By providing a safe and reliable means of access, this device will significantly contribute to the child’s well-being and improved outcomes. [2]

However, current CVAD practices may vary between individuals, settings, and countries.

CVADs move across traditional disciplines and health services, with multiple specialties (e.g., infectious disease, surgery, anaesthetics) and their primary team involved in their selection, insertion, use and removal.

In 2015 an Australian point prevalence audit in tertiary pediatrics described considerable variability in the insertion, management and removal management between departments and hospitals [3]. However, the current CVAD practices, and potential variability, in pediatric cancer care is less clear, and this is a population at high risk for adverse outcomes. [4]

We want to understand how these devices are used in pediatric cancer care in different healthcare services, internationally.

While current CVAD practices are likely to be based on guidelines, many individual recommendations do not have high-quality evidence. Regional variations in CVAD practice may also be due to tradition, opinion, and resource availability rather than best practice [5]. However, undirected diversity in clinical practice rarely leads to quality clinical outcomes. Therefore, it is important to understand the current situation and identify the variations in usual practices for future management changes.

Please help us improve patient care by sharing your experiences with CVADs in pediatric cancer care.

We aim to describe the current CVAD practice in paediatric cancer care by exploring and comparing CVAD selection, insertion, management, and complication management practices. These results will be used to target improvements and innovations in practice.

WHO CAN PARTICIPATE?

Clinicians (doctors, nurses, vascular access specialists), who are involved in CVAD practice (selection, inserting, management and removal of CVADs) in their pediatric cancer setting are eligible to respond to our survey.

Are you involved in the insertion, management, or removal of CVADs in your pediatric cancer setting? If so, your valuable participation can improve pediatric oncology CVAD practice.

AUTHORS:

DR. AREUM HYUN, MARI TAKASHIMA PROF. AMANDA ULLMAN (THE UNIVERSITY OF QUEENSLAND, AUSTRALIA)

If you do not use CVADs in your pediatric oncology practice, please share your current associated practice (e.g., use of peripheral intravenous catheters) on the first page.

How To Paricipate

To participate, Click here CVAD survey. Or scan the QR code.

If you have any questions or would like additional information, please contact Professor Amanda Ullman at a.ullman@uq.edu.au

This study has been approved the University of Queensland Human Research Ethics Committee (#2023/HE000076). If you have concerns or complaints about this research, please contact the Chair of the HREC on +617 3365 3924 / +617 3443 1656 or email humanethics@research.uq.edu.au.

References

1. Ullman, A.J., et al., Complications of Central Venous Access Devices: A Systematic Review. Pediatrics, 2015. 136(5): p. e1331-44.

2. Ullman, A.J., et al., Prevention of occlusion of cEnTral lInes for children with cancer: An implementation study. Journal of Paediatrics & Child Health, 2020. 56(12): p. 1875-1884.

3. Ullman, A.J., et al., Road map for improvement: Point prevalence audit and survey of central venous access devices in paediatric acute care. Journal of Paediatrics and Child Health, 2017. 53(2): p. 123-130.

4. Ullman, A.J., et al., Road map for improvement: Point prevalence audit and survey of central venous access devices in paediatric acute care. J Paediatr Child Health, 2017. 53(2): p. 123130.

5. Ullman, A.J., et al., Global Pediatric Peripheral Intravenous Catheter Practice and Performance: A Secondary Analysis of 4206 Catheters. J Pediatr Nurs, 2020. 50: p. e18-e25.