Wounds and Injuries
Conditions
Interventions
This is a quasi-experimental, pre-post intervention study to be conducted in two Pediatric Intensive Care Units. A total of 710 skin observations will be performed—355 in the pre-intervention period a
assessment and documentation of the skin condition and any catheter-associated skin complications, as well as a brief survey of parents or guardians regarding nursing care provided for the skin around
Sponsors
Hospital Infantil Joana de Gusmão
Programa de Pós-Graduação em Enfermagem da Universidade Federal de Santa Catarina
Eligibility
Age
No minimum to 15 Years
Inclusion criteria
Inclusion criteria: Children and adolescents (0 to 15 years; both sexes) admitted to the Pediatrics Intesive Care Unit with a centrally inserted venous catheter or peripherally inserted central catheter placed post-admission who are clinically stable and have an expected minimum stay of 48 hours; Nurses working in the Pediatrics Intesive Care Unit during the study; Parents or legal guardians present during data collection
Exclusion criteria
Exclusion criteria: Children and adolescents with significant clinical deterioration; pre-existing skin complications at the insertion site; discharge, death or transfer before 48 hours; use of non-eligible central venous devices (e.g., umbilical); refusal or withdrawal by the participant or guardian; Withdrawal by nurses or guardians at any stage
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expected outcome 1: An improvement in the documentation of skin assessment and nurse decision-making regarding skin complications related to the Central Venous Access Device (CVAD) is expected. This outcome will be assessed through medical record review by first classifying the presence of a decision (documented or absent) and, when documented, then classifying its appropriateness (appropriate or inappropriate according to the CVAD-Associated Skin Injury (CASI) Algorithm) and the completeness (complete or incomplete) of the recorded decision;Outcome found 1: A significant increase was observed in the documentation of skin assessment at the CVAD insertion site following the educational intervention, rising from 21% (76/362) in the pre-intervention phase to 50.3% (180/358) in the post-intervention phase (p<0.001). Additionally, among the skin assessments documented, there was an increase in the identification of skin complications (from 9.2% to 22.8%, p=0.018), with intact skin remaining the predominant finding in both periods | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected outcome 2: An improvement in the documentation of Central Venous Access Device (CVAD) dressing management is expected. This outcome will be assessed through medical record review by classifying the presence (documented or absent) of records regarding dressing change or maintenance and the completeness (complete or incomplete) of the recorded information;Outcome 2 found: A significant increase was observed in the documentation of CVAD dressing management following the intervention, with overall dressing registration rising from 38.4% (139/362) to 48.3% (173/358) (p=0.008). There was also a significant increase in the documentation of the dressing change date (from 26.2% to 38.8%, p<0.001), the type of dressing used (from 24.9% to 48.4%, p<0.001), and the recorded clinical decision regarding the dressing (from 39.8% to 54.7%, p<0.001) | — |
Countries
BR
Contacts
Public ContactSayonara de Moura
Universidade Federal de Santa Catarina
Outcome results
None listed