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126 Comparisons of Negative and Positive Intravenous Connectors to an Intraluminal Protection Device Connector on Infection Rates in Oncology
Poster Presentations / European Journal of Oncology Nursing 16S1 (2012) S21–S46
multiprofessional approach, of which nurses are an integral element. 125 Using Technology to Enhance Learning in Adolescent Cancer Care Education M. Cable1 , N. Pettitt2 . 1 Coventry University, Senior Lecturer Adolescent & Adult Cancer Care, Nursing and Health Studies, Coventry, United Kingdom; 2 Lecturer in Teenage/Adolescent Cancer Care in association with Teenage Cancer Trust, Coventry University, United Kingdom In recent years, health education has seen the emergence of online learning as a means of delivering education programmes for health care professionals and Coventry University in the UK have at least 6 years of experience in delivering online learning programmes. One example is the Post Graduate Certificate in Cancer Care for Teenagers and Young Adults, Cable and Parr (2009). Such programmes are designed to meet the needs on inter-professional and international students and are well evaluated. All elements of teaching and learning are based within a Virtual Learning Environment (VLE). Several modules have been developed in association with expert clinical practitioners, senior academics and in collaboration with the charity Teenage Cancer Trust. This presentation will outline some of the e-learning approaches and demonstrate some reusable learning objects that have been developed for such programmes such as video interviews, ask the expert facility, user involvement, a notional ‘seabag’ to consider palliative care aspects. This presentation will also report on some stakeholder feedback on this type of learning showing how technology can help students grow and learn and address some of the counter effects that may also occur. The discussion forum postings in particular demonstrate deeper learning. Key features of incidental learning have included networking, safety in ‘speaking in the online environment’, documentary evidence of learning, shared passion for working in specific field so of care and reasserting one’s own thinking. The poster will outline the benefits and challenges of developing education in this way focussing on the collaboration of expertise from clinical, educational, technological and patient perspectives. There is also the further potential for App development. Given the nature of the changing service, education and clinical needs in these fields coupled with the challenge of accessing specialist courses, we can capitalise on technology for support. The paper will conclude with take home messages. Reference(s) Cable M & Parr M (2009) Evaluation of an online course on the care of teenagers and young adults with cancer. Paediatric Nursing May, Issue 4, 44–46.
126 Comparisons of Negative and Positive Intravenous Connectors to an Intraluminal Protection Device Connector on Infection Rates in Oncology C. Chernecky1 , W.R. Jarvis2 , D. Macklin3 . 1 Georgia Health Sciences University, Augusta, USA; 2 Jason & Jarvis Associates LLC Hilton Head Island SC, Hilton Head, USA; 3 Consultant, Marietta, USA Introduction: Intravenous connectors differ on design features of the septum, intraluminal fluid pathway and function. As the gate keepers of the intraluminal fluid pathway the connector’s design may affect the outcome of infection which is a major concern in oncology patient care. Institute Healthcare Improvement ranks catheter related bloodstream infections a national priority (USA). SHEA/ISDA Practice Recommendations and the FDA (USA) have concerns regarding positive mechanical valves. Research needs to compare different products to assess infection outcomes. This study’s objective was to compare infection rates of split septum, negative and positive connectors to an intraluminal protection
S45
device (IPD) connector in vitro and negative mechanical valves to an IPD connector in two oncology clinical settings. Methods: In vitro study of colony forming units (CFU), 4 types of bacteria over 96 hours, by an independent laboratory, on 20 devices of each of 3 connector types and controls. Prospective study of infection rates per 1000 catheter days when changing from negative connectors to an IPD connector over 6 and 8 months in ICU oncology and medical oncology units, respectively, in USA. Same months compared in pre and post data and both oncology settings used hand hygiene, dressing kits, alcohol to scrub the hub, chlorhexidine skin patch, and flush using saline only. Results: No statistically significant differences between total number of catheter days before or after adoption of the IPD. Negative split septum connector had enough bacteria to cause sepsis (>15 CFU) in 65% of the connectors tested (13/20), positive 30% (6/20) and IPD 15% (3/20). Total CFUs greater all 4 bacteria (Coagulase-negative staphylococci, S. aureus, E. coli, Pseudomonas) in negative (range 0–500 CFU), positive (0–375 CFU) and IPD (0–42 CFU) connectors. Statistically significant difference (p < 0.0008) in infection rate in oncology patients. Rates significantly higher before IPD adopted (mean = 3.3) compared to after IPD (mean = 0.25). Observational and mean decrease in infection rates seen in an ICU oncology unit (infection rates decreased 2.8 per 1000 catheter days when changing from a negative split septum connector to an IPD) and in a medical oncology unit when changing form a negative connector to an IPD (infection rate decreased 3.3). Conclusions: Infection rates in vitro were greatest with a negative split septum connector followed by the positive connector and very low in the IPD connector. Infection rates in oncology ICU and medical oncology patients significantly dropped when changing from negative connectors to an IPD connector. Connector design does impact infection outcomes in oncology. 127 Nurses’ Knowledge and Practices on Targeted Therapies in Turkey S. Kav1 , S. Atay2 . 1 Baskent University, Department of Nursing and Health Services – Department of Nursing, Baglica – Ankara, Turkey; 2 Hacettepe University Oncology Institute, Nursing, Ankara, Turkey Introduction: The number of targeted agents has increased over the last years. Many of the targeted agents available for clinical use today are effective both as single agents and in combination with other therapies for wide range of tumors. Aim of this study was to explore current practice and knowledge of nurses about targeted therapies and to identify the gap in its management in Turkey. Materials and Method: Nurses who attended to the oncology nursing educational programs organised by Turkish Oncology Nursing Association were invited to participate. Total of 154 nurses from 28 cities were responded. Data were collected via 30 item questionnaire on demographics, knowledge and practices on targeted therapies. Following after this survey nurses invited to participate ‘target’ courses. Results and Discussion: Findings showed that most of nurses were working at university or state hospitals as clinical nurse. Mean years in nursing was 10 years (range 1–30 years) and duration of working in oncology was 3.4 years (range: 1–23 years). More than half of them (55.8%) were stated to receiving information on targeted therapies mostly through in-service education (37.7%); however most of them were partly (65.9%) or not satisfied (27.5 %) with their knowledge. Majority stated not having in-service education and protocol/practice guideline specifically for targeted therapies. Only few explained what targeted therapies are and how they work. Mean number of the targeted agents administered by nurses was 4 (range 1–10 agents) and nearly half of them were administering targeted therapies every day/week. When examined their practices on storing and handling; most of them were responded correctly however few (2.2%) responded
multiprofessional approach, of which nurses are an integral element. 125 Using Technology to Enhance Learning in Adolescent Cancer Care Education M. Cable1 , N. Pettitt2 . 1 Coventry University, Senior Lecturer Adolescent & Adult Cancer Care, Nursing and Health Studies, Coventry, United Kingdom; 2 Lecturer in Teenage/Adolescent Cancer Care in association with Teenage Cancer Trust, Coventry University, United Kingdom In recent years, health education has seen the emergence of online learning as a means of delivering education programmes for health care professionals and Coventry University in the UK have at least 6 years of experience in delivering online learning programmes. One example is the Post Graduate Certificate in Cancer Care for Teenagers and Young Adults, Cable and Parr (2009). Such programmes are designed to meet the needs on inter-professional and international students and are well evaluated. All elements of teaching and learning are based within a Virtual Learning Environment (VLE). Several modules have been developed in association with expert clinical practitioners, senior academics and in collaboration with the charity Teenage Cancer Trust. This presentation will outline some of the e-learning approaches and demonstrate some reusable learning objects that have been developed for such programmes such as video interviews, ask the expert facility, user involvement, a notional ‘seabag’ to consider palliative care aspects. This presentation will also report on some stakeholder feedback on this type of learning showing how technology can help students grow and learn and address some of the counter effects that may also occur. The discussion forum postings in particular demonstrate deeper learning. Key features of incidental learning have included networking, safety in ‘speaking in the online environment’, documentary evidence of learning, shared passion for working in specific field so of care and reasserting one’s own thinking. The poster will outline the benefits and challenges of developing education in this way focussing on the collaboration of expertise from clinical, educational, technological and patient perspectives. There is also the further potential for App development. Given the nature of the changing service, education and clinical needs in these fields coupled with the challenge of accessing specialist courses, we can capitalise on technology for support. The paper will conclude with take home messages. Reference(s) Cable M & Parr M (2009) Evaluation of an online course on the care of teenagers and young adults with cancer. Paediatric Nursing May, Issue 4, 44–46.
126 Comparisons of Negative and Positive Intravenous Connectors to an Intraluminal Protection Device Connector on Infection Rates in Oncology C. Chernecky1 , W.R. Jarvis2 , D. Macklin3 . 1 Georgia Health Sciences University, Augusta, USA; 2 Jason & Jarvis Associates LLC Hilton Head Island SC, Hilton Head, USA; 3 Consultant, Marietta, USA Introduction: Intravenous connectors differ on design features of the septum, intraluminal fluid pathway and function. As the gate keepers of the intraluminal fluid pathway the connector’s design may affect the outcome of infection which is a major concern in oncology patient care. Institute Healthcare Improvement ranks catheter related bloodstream infections a national priority (USA). SHEA/ISDA Practice Recommendations and the FDA (USA) have concerns regarding positive mechanical valves. Research needs to compare different products to assess infection outcomes. This study’s objective was to compare infection rates of split septum, negative and positive connectors to an intraluminal protection
S45
device (IPD) connector in vitro and negative mechanical valves to an IPD connector in two oncology clinical settings. Methods: In vitro study of colony forming units (CFU), 4 types of bacteria over 96 hours, by an independent laboratory, on 20 devices of each of 3 connector types and controls. Prospective study of infection rates per 1000 catheter days when changing from negative connectors to an IPD connector over 6 and 8 months in ICU oncology and medical oncology units, respectively, in USA. Same months compared in pre and post data and both oncology settings used hand hygiene, dressing kits, alcohol to scrub the hub, chlorhexidine skin patch, and flush using saline only. Results: No statistically significant differences between total number of catheter days before or after adoption of the IPD. Negative split septum connector had enough bacteria to cause sepsis (>15 CFU) in 65% of the connectors tested (13/20), positive 30% (6/20) and IPD 15% (3/20). Total CFUs greater all 4 bacteria (Coagulase-negative staphylococci, S. aureus, E. coli, Pseudomonas) in negative (range 0–500 CFU), positive (0–375 CFU) and IPD (0–42 CFU) connectors. Statistically significant difference (p < 0.0008) in infection rate in oncology patients. Rates significantly higher before IPD adopted (mean = 3.3) compared to after IPD (mean = 0.25). Observational and mean decrease in infection rates seen in an ICU oncology unit (infection rates decreased 2.8 per 1000 catheter days when changing from a negative split septum connector to an IPD) and in a medical oncology unit when changing form a negative connector to an IPD (infection rate decreased 3.3). Conclusions: Infection rates in vitro were greatest with a negative split septum connector followed by the positive connector and very low in the IPD connector. Infection rates in oncology ICU and medical oncology patients significantly dropped when changing from negative connectors to an IPD connector. Connector design does impact infection outcomes in oncology. 127 Nurses’ Knowledge and Practices on Targeted Therapies in Turkey S. Kav1 , S. Atay2 . 1 Baskent University, Department of Nursing and Health Services – Department of Nursing, Baglica – Ankara, Turkey; 2 Hacettepe University Oncology Institute, Nursing, Ankara, Turkey Introduction: The number of targeted agents has increased over the last years. Many of the targeted agents available for clinical use today are effective both as single agents and in combination with other therapies for wide range of tumors. Aim of this study was to explore current practice and knowledge of nurses about targeted therapies and to identify the gap in its management in Turkey. Materials and Method: Nurses who attended to the oncology nursing educational programs organised by Turkish Oncology Nursing Association were invited to participate. Total of 154 nurses from 28 cities were responded. Data were collected via 30 item questionnaire on demographics, knowledge and practices on targeted therapies. Following after this survey nurses invited to participate ‘target’ courses. Results and Discussion: Findings showed that most of nurses were working at university or state hospitals as clinical nurse. Mean years in nursing was 10 years (range 1–30 years) and duration of working in oncology was 3.4 years (range: 1–23 years). More than half of them (55.8%) were stated to receiving information on targeted therapies mostly through in-service education (37.7%); however most of them were partly (65.9%) or not satisfied (27.5 %) with their knowledge. Majority stated not having in-service education and protocol/practice guideline specifically for targeted therapies. Only few explained what targeted therapies are and how they work. Mean number of the targeted agents administered by nurses was 4 (range 1–10 agents) and nearly half of them were administering targeted therapies every day/week. When examined their practices on storing and handling; most of them were responded correctly however few (2.2%) responded