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21 Central venous catheter infections: from knowledge to practice
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Abstracts and Learning Outcomes / European Journal of Oncology Nursing 18S1 (2014) S1–S22
materials are insufficient especially for understanding of patients with low health literacy level. When preparing materials readability level of the target group must be considered. Therefore, the purpose of this study is to determine the level of health literacy and the needs of patients receiving radiotherapy and their relatives in order to develop a written educational material and then to evaluate the effectiveness of the educational material. Material and Method: This study was conducted at a large oncology hospital located in Ankara, Turkey and planned in two phases. The first phase; the health literacy level is determined with using ‘Rapid Estimated Adult Literacy in Medicine – REALM’ scale and NVS (Newest Vital Sign) scales and information needs identified via questionnaire. The sample determined with using power analysis; included 200 patients and 200 relatives for the first part of the study. On the second phase the educational material will be developed according to the health literacy level and the needs. The material will be assessed by experts with using ‘Evaluation of the written materials appropriateness’ form, in terms of the level of literacy SMOG readability formula, for reliability and quality of information DISCERN (Quality Criteria for Consumer Health Information) tool. Results and Discussion: The average age for patients and relatives were 52.7±12.2 (19–77) and 44.8±12.8 (19–70) respectively. Patients (68%) and relatives (58.5%) were mostly educated primary level. The mean scores for REALM were 55.8±11.2 (range: 23–66) for patients and for relatives were 57.3±9.5 (range: 25–66) that indicates 7th to 8th grade means that will struggle with most patient education materials. The mean scores for NVS was 0.97±1.6 for patients and 1.3±1.9 (range: 0–6) for relatives which shows limited literacy. All the patients and relatives needed information however majority of them (77% patients and 73% relatives) did not receive any education. Those who indicated to receiving education only 25.5% patients and 35% relatives were satisfied. Majority of the patients and relatives preferred written material and verbal education before beginning to radiotherapy. Written educational material developed to meet the needs and the health literacy of the group. The material has been for experts review. Conclusion: The result showed that most of the patients and relatives have low literacy level and information needs for managing their treatment process. *Funding with support from TUBITAK (project no: 114S074). No conflict of interest. 21 Central venous catheter infections: from knowledge to practice A. Graca ¸ 1 . 1 Instituto Portugues de Oncologia, Unidade de Transplantac˜ ¸ ao Medular, Lisboa, Portugal Healthcare institutions and their patients are familiar with the effects of Nosocomial Infections (NI). These consequences translate to the increased suffering and extension of recovery time for the patients and diminished indexes of quality among institutions. Central venous catheter (CVC) related bloodstream infections are costly and account for a significant proportion of hospital-acquired infections. Patients submitted to hematopoietic stem cell transplantation are an exceptionally high-risk group considering their illness and severity of treatment, which demands a CVC. The safety of the patients concerning this device depends on the nursing care. To help reduce the incidence of this complication it is imperative to know the pathogenesis and patient related risk factors, as well as to apply the international guidelines of Infection Control Prevention. The aim of this investigation was to assess current practice and staff knowledge of CVC post-insertion care and therefore identify aspects of CVC care with potential for improvement. With the help of two methodological validated instruments (questionnaire and a procedure check list) it was possible to assess the attitudes and practices of the nurses handling the CVC at the
Hematopoietic Stem Cell Transplant Unit in Instituto Portuguˆes de Oncologia de Lisboa. Conclusion: It was shown that positive attitudes and practices are those concerning nail care, the use of 70° alcohol to disinfect the connecting valve, the use of a sterile dressing to protect the insertion site and the change of administration sets every 24 h when blood products and lipidic solutions are infused. It was also found that there are technical details that can be optimized such as the use of 2% chlorhexidine gluconate to disinfect the insertion site, the use of a single line to infuse blood products and lipidic solutions and hygiene in the post-handling procedure. Reducing the rates of CVC bloodstream infections requires a multiple approach that includes updating protocols and developing educational strategies with an emphasis on specific problems observed during a careful evaluation of CVC care practices. The conclusions of this study highlight the need to increase awareness among practitioners as a bundles strategy to improve healthcare safety. No conflict of interest.
Parallel Session: EMBT / EONS: Chemo-induced Neutropenia 22 Introduction about benefits of working together, EBMT and EONS No abstract received. No conflict of interest information specified. 23 General management of neutropenic patients P. Crombez1 . 1 Institut Jules Bordet, Department of Haematology and Stem Cell Transplantation, Bruxelles, Belgium Neutropenia is the most common dose-limiting toxicity (concept Relative Dose Intensity) of cancer chemotherapy, and complications from chemotherapy-induced neutropenia (CIN) as febrile neutropenia (FN) can cause significant morbidity and mortality. In fact, Given and Sherwood (2005) identified CIN as a nursing-sensitive patient outcome symptom. Expert nursing assessment, intervention, evaluation, education and research facilitate patient management in both inpatient and community settings. The most significant outcome of CIN in patients with cancer is death as a result of infection and sepsis. Therefore pro-active nursing intervention is crucial regarding to prevention and management of complications of neutropenia. The lecture will highlight the importance of risk assessment, prevention and management of infection in cancer patients and how to do it based not on tradition or expert opinion but research based evidence. Pharmacologic and non pharmacologic interventions will both be included. The creation of risk models to predict outcomes for patients who develop FN enables healthcare providers to identify patients who likely would have an uncomplicated recovery and those most likely to suffer major complications. Evidence with regard to the optimal methods for risk assessment of neutropenia, the best tools to use in busy clinic practices, how to communicate risk and documented assessments to others on the healthcare team, and means of tracking outcomes related to assessments is lacking in the clinical practice setting. Some clinical practices may work well using standing orders or algorithms derived directly from evidence-based guidelines. The same reasoning can be hold regarding to pro-active nursing management of neutropenic complications. Considerable gaps in established evidence exist in the areas of clinical practice, research, and education as related to the prevention
Abstracts and Learning Outcomes / European Journal of Oncology Nursing 18S1 (2014) S1–S22
materials are insufficient especially for understanding of patients with low health literacy level. When preparing materials readability level of the target group must be considered. Therefore, the purpose of this study is to determine the level of health literacy and the needs of patients receiving radiotherapy and their relatives in order to develop a written educational material and then to evaluate the effectiveness of the educational material. Material and Method: This study was conducted at a large oncology hospital located in Ankara, Turkey and planned in two phases. The first phase; the health literacy level is determined with using ‘Rapid Estimated Adult Literacy in Medicine – REALM’ scale and NVS (Newest Vital Sign) scales and information needs identified via questionnaire. The sample determined with using power analysis; included 200 patients and 200 relatives for the first part of the study. On the second phase the educational material will be developed according to the health literacy level and the needs. The material will be assessed by experts with using ‘Evaluation of the written materials appropriateness’ form, in terms of the level of literacy SMOG readability formula, for reliability and quality of information DISCERN (Quality Criteria for Consumer Health Information) tool. Results and Discussion: The average age for patients and relatives were 52.7±12.2 (19–77) and 44.8±12.8 (19–70) respectively. Patients (68%) and relatives (58.5%) were mostly educated primary level. The mean scores for REALM were 55.8±11.2 (range: 23–66) for patients and for relatives were 57.3±9.5 (range: 25–66) that indicates 7th to 8th grade means that will struggle with most patient education materials. The mean scores for NVS was 0.97±1.6 for patients and 1.3±1.9 (range: 0–6) for relatives which shows limited literacy. All the patients and relatives needed information however majority of them (77% patients and 73% relatives) did not receive any education. Those who indicated to receiving education only 25.5% patients and 35% relatives were satisfied. Majority of the patients and relatives preferred written material and verbal education before beginning to radiotherapy. Written educational material developed to meet the needs and the health literacy of the group. The material has been for experts review. Conclusion: The result showed that most of the patients and relatives have low literacy level and information needs for managing their treatment process. *Funding with support from TUBITAK (project no: 114S074). No conflict of interest. 21 Central venous catheter infections: from knowledge to practice A. Graca ¸ 1 . 1 Instituto Portugues de Oncologia, Unidade de Transplantac˜ ¸ ao Medular, Lisboa, Portugal Healthcare institutions and their patients are familiar with the effects of Nosocomial Infections (NI). These consequences translate to the increased suffering and extension of recovery time for the patients and diminished indexes of quality among institutions. Central venous catheter (CVC) related bloodstream infections are costly and account for a significant proportion of hospital-acquired infections. Patients submitted to hematopoietic stem cell transplantation are an exceptionally high-risk group considering their illness and severity of treatment, which demands a CVC. The safety of the patients concerning this device depends on the nursing care. To help reduce the incidence of this complication it is imperative to know the pathogenesis and patient related risk factors, as well as to apply the international guidelines of Infection Control Prevention. The aim of this investigation was to assess current practice and staff knowledge of CVC post-insertion care and therefore identify aspects of CVC care with potential for improvement. With the help of two methodological validated instruments (questionnaire and a procedure check list) it was possible to assess the attitudes and practices of the nurses handling the CVC at the
Hematopoietic Stem Cell Transplant Unit in Instituto Portuguˆes de Oncologia de Lisboa. Conclusion: It was shown that positive attitudes and practices are those concerning nail care, the use of 70° alcohol to disinfect the connecting valve, the use of a sterile dressing to protect the insertion site and the change of administration sets every 24 h when blood products and lipidic solutions are infused. It was also found that there are technical details that can be optimized such as the use of 2% chlorhexidine gluconate to disinfect the insertion site, the use of a single line to infuse blood products and lipidic solutions and hygiene in the post-handling procedure. Reducing the rates of CVC bloodstream infections requires a multiple approach that includes updating protocols and developing educational strategies with an emphasis on specific problems observed during a careful evaluation of CVC care practices. The conclusions of this study highlight the need to increase awareness among practitioners as a bundles strategy to improve healthcare safety. No conflict of interest.
Parallel Session: EMBT / EONS: Chemo-induced Neutropenia 22 Introduction about benefits of working together, EBMT and EONS No abstract received. No conflict of interest information specified. 23 General management of neutropenic patients P. Crombez1 . 1 Institut Jules Bordet, Department of Haematology and Stem Cell Transplantation, Bruxelles, Belgium Neutropenia is the most common dose-limiting toxicity (concept Relative Dose Intensity) of cancer chemotherapy, and complications from chemotherapy-induced neutropenia (CIN) as febrile neutropenia (FN) can cause significant morbidity and mortality. In fact, Given and Sherwood (2005) identified CIN as a nursing-sensitive patient outcome symptom. Expert nursing assessment, intervention, evaluation, education and research facilitate patient management in both inpatient and community settings. The most significant outcome of CIN in patients with cancer is death as a result of infection and sepsis. Therefore pro-active nursing intervention is crucial regarding to prevention and management of complications of neutropenia. The lecture will highlight the importance of risk assessment, prevention and management of infection in cancer patients and how to do it based not on tradition or expert opinion but research based evidence. Pharmacologic and non pharmacologic interventions will both be included. The creation of risk models to predict outcomes for patients who develop FN enables healthcare providers to identify patients who likely would have an uncomplicated recovery and those most likely to suffer major complications. Evidence with regard to the optimal methods for risk assessment of neutropenia, the best tools to use in busy clinic practices, how to communicate risk and documented assessments to others on the healthcare team, and means of tracking outcomes related to assessments is lacking in the clinical practice setting. Some clinical practices may work well using standing orders or algorithms derived directly from evidence-based guidelines. The same reasoning can be hold regarding to pro-active nursing management of neutropenic complications. Considerable gaps in established evidence exist in the areas of clinical practice, research, and education as related to the prevention