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  • Skin Complications Associated With Pediatric Central Venous Access Devices: Prevalence, Incidence, and Risk

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    Ullman222267.pdf (240.6Kb)
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    Accepted Manuscript (AM)
    Author(s)
    Ullman, Amanda J
    Kleidon, Tricia M
    Turner, Karen
    Gibson, Victoria
    Dean, Anna
    Cattanach, Paula
    Pitt, Colleen
    Woosley, Julieta
    Marsh, Nicole
    Gavin, Nicole
    Takashima, Mari
    Rickard, Claire M
    Griffith University Author(s)
    Ullman, Amanda J.
    Rickard, Claire
    Kleidon, Patricia
    Gavin, Nicole C.
    Takashima, Mari
    Marsh, Nicole M.
    Gibson, Victoria
    Year published
    2019
    Metadata
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    Abstract
    Central venous access devices (CVADs) are vital to enable treatment for children with cancer and other complex health conditions. However, complications effecting the CVAD wound are commonly reported. This study aimed to identify the incidence and prevalence of CVAD-associated skin complications current management, and characteristics associated with complication development, in pediatrics. A prospective observational study performed across medical, oncology, and hematology departments at a tertiary pediatric hospital in Australia, between April and July 2017. Children admitted with CVADs were assessed twice weekly for ...
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    Central venous access devices (CVADs) are vital to enable treatment for children with cancer and other complex health conditions. However, complications effecting the CVAD wound are commonly reported. This study aimed to identify the incidence and prevalence of CVAD-associated skin complications current management, and characteristics associated with complication development, in pediatrics. A prospective observational study performed across medical, oncology, and hematology departments at a tertiary pediatric hospital in Australia, between April and July 2017. Children admitted with CVADs were assessed twice weekly for CVAD-associated skin complications and associated signs and symptoms. The data were analyzed using descriptive statistics (i.e., proportions, frequency) and time-to-event multivariable regression (i.e., hazard ratios [HRs]). Two hundred and seventy-one CVADs were reviewed over 43,787 catheter days, with over one eighth of participants (14%; n = 37) having a CVAD-associated skin complication during their admission (0.95 per 1,000 catheter days, 95% confidence interval [CI; 0.61, 1.17]), most commonly contact dermatitis (11%; n = 29; 0.72 per 1,000 catheter days 95% CI [0.50, 1.04]). Within biweekly checks the median point prevalence of complications varied between 0.4% and 11% and clinical management was wide-ranging. A primary diagnosis of oncology (HR 2.89, 95% CI [1.10, 7.62]) or medical/surgical (HR 2.55, 95% CI [1.04, 6.22]) conditions; plain, nonbordered polyurethane dressings (HR 4.92, 95% CI [2.00, 12.13]); and poor dressing integrity (HR 2.64, 95% CI [1.18, 5.92]) were significantly associated with contact dermatitis. In conclusion, substantial numbers of pediatric patients experience CVAD-associated skin complications, and innovations are necessary to identify, prevent, and treat these health care–associated injuries.
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    Journal Title
    Journal of Pediatric Oncology Nursing
    DOI
    https://doi.org/10.1177/1043454219849572
    Copyright Statement
    Ullman, et al., Skin Complications Associated With Pediatric Central Venous Access Devices: Prevalence, Incidence, and Risk, Journal of Pediatric Oncology Nursing. Copyright 2019 The Authors. Reprinted by permission of SAGE Publications.
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version.
    Subject
    Nursing
    Oncology and carcinogenesis
    Publication URI
    http://hdl.handle.net/10072/386430
    Collection
    • Journal articles

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