Navigating Challenges in Pediatric Cancer Care: Insights from Central Venous Catheter Occlusion Management

Central venous access devices (CVADs) are lifelines in healthcare, especially in pediatric cancer care. However, concerns persist about the high incidence of CVAD occlusions disrupting treatments. A recent qualitative study delved into the decision-making and problem-solving processes surrounding CVAD occlusion management in this critical setting.

Study Overview

Researchers conducted individual semi-structured interviews with 13 clinicians and 5 parents at a tertiary-referral pediatric facility. The goal was to understand how occlusion issues were addressed and to pinpoint factors influencing the implementation of evidence-based occlusion management guidelines.

Key Findings

The study unearthed four pivotal themes in decision-making and problem-solving:

Clinical Reasoning: Clinicians relied on their judgment and reasoning skills to manage CVAD occlusions, sometimes diverging from evidence-based practices.
Capability: The ability to manage CVAD occlusions varied, with prior experience playing a crucial role.
Collaboration: Teamwork and collaboration among colleagues were essential, especially in escalating issues.
Support: Lack of adequate support and resources posed challenges in occlusion management.

Implications

The findings underscored the significance of a collaborative approach and clinician experience in CVAD occlusion management within pediatric oncology. However, there were instances where clinical decisions conflicted with evidence-based practices, highlighting the need for improved alignment. Enhanced documentation and visual aids were suggested as potential aids to streamline problem-solving processes.

Conclusion

Managing CVAD occlusions in pediatric cancer care involves a complex interplay of clinical judgment, teamwork, and resource availability. Bridging gaps between clinical practices and evidence-based guidelines is crucial for optimizing patient outcomes. This study sheds light on the challenges and opportunities in CVAD occlusion management, paving the way for targeted interventions and improved protocols in pediatric oncology settings.

Read More:https://pubmed.ncbi.nlm.nih.gov/38394934/ 

Authors: Areum Hyun, Paula Condon, Tricia Kleidon, Grace Xu, Rachel Edwards, Victoria Gibson, Amanda Ullman