Secola, R., Lewis, M. A., Pike, N., Needleman, J., & Doering, L. (2012). "Targeting to zero" in pediatric oncology: a review of central venous catheter-related bloodstream infections. Journal of Pediatric Oncology Nursing, 29, 14–27.
To summarize existing adult and pediatric data on central venous catheter (CVC)-related bloodstream infections (BSIs) and identify models of care that can improve pediatric oncology outcomes.
Databases searched were PubMed, CINAHL, and Google Scholar (1998–2010).
Keywords searched were CVC, BSI, and pediatric oncology.
Patients were included if they
No exclusion criteria were specified.
Strategies to reduce CVC-related BSIs reported were summarized. In regard to insertion site selection and catheter type, some data supported the use of an externalized catheter versus a port in children. Use of impregnated catheters in children is controversial. Evidence-based guidelines (CVC “bundles”) have been shown to be effective to reduce BSI rates.
Bundles include
For CVC education, studies showed that annual education enhanced adherence to policy.
Findings suggested that the implementation of CVC care bundles was effective in reducing CVC-related BSI rates.
Most studies involved critical care patients and not necessarily those with cancer who would be more immunocompromised. There was limited research information on pediatric oncology cases.
This review supported the use of CVC care bundles to reduce rates of CVC-related BSIs. Findings suggested that regular and repeated education on CVC care can improve adherence to care protocols.