University of Cincinnati College of Medicine, Department of Surgery, Cincinnati, OH (Drs Wagner and Falcone); Cincinnati Children's Hospital Medical Center, Pediatric General and Thoracic Surgery, Cincinnati, OH (Mss Doellman, Forlenza, and Bradshaw; Drs Fischer, Kara, and Falcone). Monica L. Wagner, MD, is a general surgery resident in the Department of Surgery at the University of Cincinnati College of Medicine. Darcy Doellman, MSN, RN, CRNI®, VA-BC, is a clinical manager of the vascular access team at Cincinnati Children's Hospital Medical Center. She has extensive expertise and is nationally recognized in the field of pediatric vascular access. Kimberly N. Forlenza, MS, participated in this work as part of the special master's program in physiology at the University of Cincinnati College of Medicine, Department of Pharmacology & Systems Physiology. Kevin Fischer, DNP, APRN, is an advanced practice provider in pediatric surgery at Cincinnati Children's Hospital Medical Center, Division of Pediatric General and Thoracic Surgery. Setenay Tuncel Kara, PhD, is a lead quality improvement specialist in the James M. Anderson Center for Health Systems Excellence at Cincinnati Children's Hospital Medical Center. She has worked on numerous quality improvement initiatives across the hospital. Ursula Bradshaw, MA, BS, is a quality analyst at Cincinnati Children's Hospital Medical Center, Quality & Transformation Analytics and Data. Richard A. Falcone, Jr, MD, MPH, MMM, is a professor of surgery in the Department of Surgery at the University of Cincinnati College of Medicine practicing within the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center. He is also the associate chief of staff for surgical services, responsible for oversight of operations.
J Infus Nurs. 2020 Sep/Oct;43(5):262-274. doi: 10.1097/NAN.0000000000000386.
Central vascular access device (CVAD) placement is a common procedure in children. When selecting a CVAD, available evidence and specified indications should be used to choose the device that best supports the patient's treatment and carries the lowest risks. A multidisciplinary team developed a care algorithm to standardize preoperative screening before pediatric CVAD placement, with 3 major parts: CVAD selection, patient risk stratification, and preoperative evaluation. Using a stepwise approach of provider education and incorporation into the electronic health record, the team achieved 82% stratification among inpatients. The team's algorithm integrates the existing literature and recommendations for safe and effective CVAD placement.
中心血管通路装置（CVAD）的置管是儿童中常见的一种操作。在选择 CVAD 时，应利用现有证据和特定适应证来选择最能支持患者治疗且风险最低的装置。一个多学科团队制定了一个护理算法，以标准化儿童 CVAD 置管前的术前筛查，主要包括 3 个部分：CVAD 选择、患者风险分层和术前评估。通过分阶段对医务人员进行教育并将其纳入电子病历，该团队实现了 82%的住院患者分层。该团队的算法整合了现有的关于安全有效 CVAD 置管的文献和推荐意见。
