Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in...

Area of Science:

• Pediatric healthcare research
• Implementation science
• Clinical intervention effectiveness

Background:

• Central venous access devices (CVADs) are crucial for pediatric patients with complex conditions.
• CVAD complications, such as infections, affect nearly one-third of patients.
• Evidence-based practices can mitigate these complications.

Purpose of the Study:

• To explore recent interventional research on pediatric CVAD management.
• To examine these interventions through an implementation science lens.

Main Methods:

• A scoping review using the Arksey and O'Malley framework.
• Searches across major databases (EMBASE, CINAHL, PubMed, Web of Science, CENTRAL).
• Inclusion of English-language studies from 2012-2023 involving children.

Main Results:

• 46 studies were included, focusing on CVAD maintenance and health professionals.
• Many studies used quality improvement approaches rather than formal implementation frameworks.
• Common strategies included education, bundles, and working groups; outcomes focused on effectiveness and infection reduction.

Conclusions:

• Translating evidence-based practices for pediatric CVADs into clinical settings is challenging.
• Adoption of formal implementation frameworks is limited, with 'quality improvement' being an exception.
• Further research should explore the link between implementation strategies, frameworks, and outcomes.