在儿科癌症护理中解决中央静脉导管封闭问题的过程:一个定性研究
Areum Hyun1, Paula Condon2, Tricia Kleidon3
1School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, QLD, Australia.
概括
临床医生在儿童癌症护理中管理中央静脉接入装置封闭,通常依赖临床判断,可能与基于证据的指导方针分歧. 加强支持和文档可以改善阻塞管理.
科学领域:
- 儿科瘤学 儿科瘤学
- 医疗保健管理的管理
- 临床实践 临床实践
背景情况:
- 中枢静脉接入装置 (CVAD) 在儿科癌症护理中至关重要,但经常出现闭塞,扰乱治疗.
- 现有的管理CVAD闭塞的指导方针被不一致地应用,这对有效的患者护理构成了挑战.
研究的目的:
- 调查参与管理CVAD封闭的决策和解决问题的过程.
- 确定使或阻碍实施基于证据的CVAD闭塞管理在儿科瘤学的实践的因素.
主要方法:
- 一项定性研究,采用与临床医生和家长的半结构面试.
- 使用有目的的抽样从第三级推儿科机构招募参与者.
主要成果:
- 对13名临床医生和5名家长的专题分析揭示了四个关键主题:闭塞管理中的临床推理,临床医生的能力,升级期间的合作,以及不充分的支持.
- 对解决问题的影响包括临床医生的心理能力,可用的资源和对治疗后果的信念.
结论:
- 儿科癌症护理临床医生有效地使用临床判断来管理CVAD封闭,尽管这有时可能与基于证据的实践相冲突.
- 团队的方法和先前的经验对于在儿科瘤学中管理CVAD闭塞至关重要.
- 在临床医生的决定和基于证据的实践之间存在潜在的冲突;改进的文档和视觉辅助工具可能会提高解决问题的能力.
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