Infections from a central line in children with cancer can be life-threatening. Today, with most cancer care taking place in the home, it is critical for parents to learn to care for central lines and prevent central line-associated bloodstream infections (CLABSIs). A new study in the May 2017 issue of the Joint Commission Journal on Quality and Patient Safety describes how simulation training for parents of children with cancer improved their knowledge and psychomotor skills regarding central-line care.
Most pediatric oncology patients require a central venous catheter, also called a central line—a long, thin, flexible tube inserted in the arm or chest through the skin into a large vein for delivering medicines, fluids, nutrients or blood products over a long period of time. In the study, “Becoming Parent and Nurse: High-Fidelity Simulation in Teaching Ambulatory Central Line Infection Prevention to Parents of Children with Cancer,” by Carol E. Heiser Rosenberg, ND, DNP, RN, and co-authors, one parent of each of 17 children with cancer at Johns Hopkins Children’s Center, Baltimore, Maryland, had received typical central-line education but still showed many gaps in understanding essential medication safety practices and the signs and symptoms of a CLABSI.
For the study, each parent then practiced central-line care in a session with a life-sized “high-fidelity” simulator—child or infant models were used, depending on the patient’s actual size. Following simulation, parents’ knowledge and psychomotor skills increased significantly. Median knowledge scores increased from pre- to post-test, from 10 to 15 of 16 points possible, and median psychomotor skills scores increased from 8 to 12 of 12 points possible. All participants also strongly agreed or agreed that simulation was meaningful for learning central-line care.
The study suggests that simulation, as an adjunct to the usual education provided, may be an effective strategy for preparing parents to use evidence-based central-line practices at home. Just as simulation has enriched the training of nursing and medical students, it also has the potential to follow suit in parent and patient education—for patients of all ages and conditions.
Source: Joint Commission