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 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research 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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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