Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
-
J Pediatr Oncol Nurs · May 2021
Improving Antibiotic Timing in Febrile Neutropenia for Pediatric Oncology Patients with a Central Line.
Background: Febrile neutropenia in pediatric oncology patients is considered a medical emergency. This population is at risk for infection-related complications due to their immunocompromised state. The purpose of this evidence-based quality improvement project was to reduce the time in minutes from admission to antibiotic administration to within 60 min in at least 90% of pediatric oncology patients with a central line presenting with febrile neutropenia. ⋯ Other outcomes included 100% compliance in provider utilization of the order set, reduction in the average time from admission to antibiotic administration, and cost reduction related to cefepime waste. Discussion: The FAST BREAK order set is now considered the standard of care in the Pediatric Cancer Center at the University of Iowa Stead Family Children's Hospital. Maintaining the expectation of prompt antibiotic administration for febrile neutropenia in pediatric oncology patients with a central line will improve patient care, reduce adverse outcomes in this vulnerable population, and correlate with national guidelines for antibiotic administration in febrile oncology patients.
-
J Pediatr Oncol Nurs · Mar 2021
Randomized Controlled TrialEffects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study.
Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years. ⋯ VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.
-
J Pediatr Oncol Nurs · Jul 2020
Randomized Controlled TrialFeasibility, Acceptability, and Clinical Implementation of an Immersive Virtual Reality Intervention to Address Psychological Well-Being in Children and Adolescents With Cancer.
Objective: Virtual reality (VR), a novel and highly immersive technology, offers promise in addressing potential psychological impacts of cancer treatments and hospitalization. The primary aim of this study was to examine multiple key user perspectives on the acceptability and feasibility of an Immersive VR therapeutic intervention for use with hospitalized patients with cancer. Secondary aims were to identify issues and opportunities related to the adoption and clinical implementation of VR in pediatric oncology settings. ⋯ Patients reported high satisfaction of the VR intervention within minimal adverse effects. Barriers and facilitators to VR use with seriously ill children and specific recommendations for content development were elicited. Conclusion: This study shows that there are several potential clinical uses for Immersive VR intervention, beyond medical procedural distraction, to support psychological adjustment to hospitalization and patient quality of life.
-
Purpose: The purpose of this study was to explore the potential risk factors for overweight/obesity in survivors of childhood cancer. Design: A retrospective chart review of childhood cancer survivors (N = 321) seen in a cancer survivor clinic was conducted to determine the strongest risks of overweight/obesity. Risk factors were as follows: age, race, gender, cancer diagnosis, body mass index at diagnosis, and treatment. ⋯ Findings: Data suggested that female cancer survivors, Hispanics, those with higher body mass index at diagnosis, and those with longer duration of treatment had greater odds of being overweight/obese. Conclusions: Many of the risk factors for overweight/obesity in childhood cancer survivors are consistent with the general population, and length of cancer treatment is unique to this population. Implications for Nursing: Findings from this study will inform care for childhood cancer survivors to improve long-term cardiovascular health.
-
J Pediatr Oncol Nurs · Jan 2020
Barriers to Palliative Care in Pediatric Oncology in Switzerland: A Focus Group Study.
Introduction: For children with cancer, early integration of pediatric palliative care in conjunction with curative treatments is recommended. In Switzerland, pediatric palliative care is mostly provided by an interdisciplinary primary oncology team that is mainly composed of nurses. However, only a small fraction of children receive pediatric palliative care and only a minority of them in a timely manner. ⋯ Data were analyzed employing applied thematic analysis. Results: Analysis revealed eleven barriers: lack of financial resources, lack of prejob education regarding pediatric palliative care, lack of awareness in politics and policy making, absence of a well-established nationwide bridging care system, insufficient psychosocial and professional supervision for staff, understaffing, inadequate infrastructure of hospitals, asymmetry of factual and emotional knowledge between parents and providers, cultural aspects, irrational parental hopes, and "the unspoken." Discussion: Awareness should be raised for pediatric palliative care (in particular in demarcation from palliative care in adults) among politics and policy makers which could lead to increased financial resources that, in turn, could be used to improve bridging care, hospital's infrastructure, and team support. More flexibility for care determining factors is needed, for example, with respect to convening team meetings, short-termed staffing, and reimbursement at the interface between inpatient and outpatient services.