Developing A Peripherally Inserted Central Catheter Picc Service Using Ultrasound Guidance In The Haematology Setting
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Developing a Peripherally Inserted Central Catheter (PICC) Service Using Ultrasound Guidance in the Haematology Setting
Many patients with a haematological disease will require some type of central venous access device (CVAD) to deliver both their anti-cancer and supportive therapies. The devices used within the haematology department at the University Hospital of Wales (UHW) in Cardiff include temporary central venous catheters (CVCs), Hickman lines and less commonly peripherally inserted central catheters (PICCs). -- In many circumstances, a Hickman line would be the device of choice with PICCs often overlooked due to issues surrounding the traditional method of insertion in the antecubital fossa (ACF). However, with the technological advances in ultrasound and recommendations from the then named National Institute for Clinical Excellence (NICE) (2002), PICCs can now be inserted away from the ACF and placed into the veins of the upper arm. -- This practice has already been performed in the United States of America (USA) in excess of 20 years and over the past 5 years many PICC placers in the United Kingdom (UK) have also changed to inserting PICCs under ultrasound guidance (USG). -- The aim of this service development project was to extend the current PICC service incorporating the technological advances and changing the method of insertion to that of USG in line with the successes shown in the literature review. The methods used included a situational analysis drawing on the internal and external forces and influences using a PEST analysis and formulating a change management strategy using Lewin's (1951) force field analysis to establish what was driving or restricting the project forward. -- The project predominately involved further training and education, identification and involvement of the core stakeholders and challenging current work patterns and the poor perceptions of PICCs by the staff.
Nathan and Oski's Hematology and Oncology of Infancy and Childhood E-Book
Author: Stuart H. Orkin
language: en
Publisher: Elsevier Health Sciences
Release Date: 2014-11-14
Written by the leading names in pediatric oncology and hematology, Nathan and Oski's Hematology and Oncology of Infancy and Childhood offers you the essential tools you need to overcome the unique challenges and complexities of childhood cancers and hematologic disorders. Meticulously updated, this exciting full-color set brings together the pathophysiology of disease with detailed clinical guidance to provide you with the most comprehensive, authoritative, up-to-date information for diagnosing and treating children. - Form a definitive diagnosis and create the best treatment plans possible with comprehensive coverage of all pediatric cancers, including less-common tumors, as well as all hematologic disorders, including newly recognized ones. - Develop a thorough, understanding of the underlying science of diseases through summaries of relevant pathophysiology balanced with clear, practical clinical guidance. Nathan and Oski's is the only comprehensive product on the market that relates pathophysiology in such depth to hematologic and oncologic diseases affecting children. - Quickly and effortlessly access the key information you need with the help of a consistent organization from chapter to chapter and from volume to volume. - Stay at the forefront of your field thanks to new and revised chapters covering topics such as paroxysmal nocturnal hemoglobinuria, lysosomal storage diseases, childhood genetic predisposition to cancer, and oncology informatics. - Learn about the latest breakthroughs in diagnosis and management, making this the most complete guide in pediatric hematology and oncology. - Discover the latest in focused molecularly targeted therapies derived from the exponential growth of knowledge about basic biology and genetics underlying the field. - Rely on it anytime, anywhere! Access the full text, images, and more at Expert Consult.
Infections in Hematology
Infections are among the most frequent complications in patients with hematological malignancies and in those undergoing high-dose chemotherapy and autologous hematopoietic stem cell transplantation. A profound knowledge on the epidemiology, diagnostic approaches, treatment modalities and prophylactic strategies is essential for the clinical management of these complications in patients who are often severely immunocompromised owing to their underlying diseases and in particular, the intensive myelosuppressive chemo and immunotherapy. This textbook provides a clinically oriented, compact and up-to-date overview on infections in hematology patients and their management. The typical pathogens to be considered in different subgroups of patients are identified and further aspects of the microbiological background are explored. Clinical, imaging, and laboratory-based diagnostic techniques are discussed and therapeutic strategies appropriate to different situations are then presented, with due attention to the pitfalls, toxicities and interactions that can arise during antimicrobial treatment. Strategies to prevent infection are also outlined, encompassing antimicrobial prophylaxis, isolation procedures, hospital hygiene, protective immunization and the use of hematopoietic growth factors.