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Purpose: This study aimed to explore current central vascular access device (CVAD) management practices in pediatric cancer care globally and compare practices across high-income and middle-income (i.e., upper middle-income and lower middle-income) countries. Methods: A descriptive cross-sectional international survey was conducted between May 2022 and December 2023. Clinicians involved in CVAD insertion/management for pediatric cancer patients were invited to participate through established clinical networks globally. The survey covered CVAD management practices, including dressings, securements, routine care, and maintenance procedures. Results: A total of 220 responses from 42 countries were received. Polyurethane dressings were most commonly used across all CVAD types (55–65/34.2–40.4). Bordered dressings were the primary securement method for all CVAD types (69–96/161, 42.9–59.6%). Routine practices varied, with 31/102 (30.4%) assessing CVADs hourly during infusion in high-income countries and 22 (37.3%) assessing every shift in middle-income countries. Heparin and normal saline were the commonly used solutions for flushing and locking. Chlorhexidine 2% in 70% alcohol was the predominant decontamination solution in high-income countries (64/102, 62.8%), while alcohol was more common in middle-income countries (22/59, 37.3%). Differences were observed between high-income and middle-income countries in the types of dressings, securements, and maintenance practices used. Conclusion: This study revealed significant variability in CVAD management practices for pediatric cancer care globally, particularly between high-income and middle-income countries. These findings highlight the need for standardized, evidence-based guidelines considering resource availability and contextual factors to improve CVAD management in pediatric oncology across diverse healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Family‐centered care (FCC) has been successfully incorporated into daily practice in many neonatal intensive care units (NICUs) worldwide. However, the implementation of FCC in lower‐resourced settings, such as Thailand, can be challenging and needs to be further explored. Aims: To identify parents' and interdisciplinary professionals' perceptions of FCC and to describe the opportunities to improve FCC in a Thai NICU. Design: An exploratory qualitative approach was used. Methods: The data were collected through face‐to‐face, semi‐structured, individual interviews based on an interview guide. This study was conducted before the outbreak of coronavirus disease 2019 (February 2020) in a hospital in southern Thailand. Inductive thematic analysis was used to analyse interview data. Results: Participants were parents (n = 9) and interdisciplinary professionals (n = 8). The results revealed four key themes: (a) Recognizing and responding to individual families' different readiness and their rights and values, (b) working in a parent‐interdisciplinary partnership to provide care, (c) lacking resources and motivation and (d) understanding of care requirements and providing help/sympathy. Conclusions: The interdisciplinary professionals accepted that FCC is necessary for clinical practice, but there are some challenges in the Thai NICUs context because of the system of health care delivery. The findings highlighted that interdisciplinary professionals often viewed parents' involvement as an obstacle to providing neonatal care. Relevance to clinical practice: Further research is recommended to investigate how FCC is operationalized by interdisciplinary professionals and how hospital administrators can be supported to implement the FCC approach into clinical practice in Thai NICUs. [ABSTRACT FROM AUTHOR]

Background: Family‐centred care (FCC) is an approach to promote family and health care provider partnership. This has been incorporated into neonatal intensive care units (NICUs) worldwide. However, FCC in low resource health settings, such as Thailand, is challenging and further impacted by coronavirus disease 2019 (COVID‐19). Aims: To evaluate FCC innovations to improve respect, collaboration and support in a Thai NICU. Study design: A quasi‐experimental study was conducted in an NICU in southern Thailand. Pre‐implementation was prior to COVID‐19, and parental and staff perceptions of FCC were measured via Perceptions of Family Centred Care‐Parent (PFCC‐P) and ‐Staff (PFCC‐S) survey. The FCC innovations were developed by stakeholders based on the COVID‐19 restrictions, pre‐survey results, parents' and clinicians' interviews and integrative review, then implemented via a flowchart. Post‐implementation evaluation was via repeated surveys. Comparisons were made pre‐and post‐implementation, with Mann–Whitney U‐test statistics for parents and Wilcoxon's Rank Sum for staff. Results: A total of 185 (85 pre; 100 post) parents and 20 (pre and post; paired group) health care professionals participated. Because of COVID‐19, many planned interventions were unfeasible, however, other innovations achieved (e.g., structured telephone updates, information booklet revision). There was an increase in parents' perception of respect ([median] 2.50–3.50), collaboration (2.33–3.33) and support (2.60–3.60) domains and overall (2.50–3.43; p <.001; 95% CI: 2.93–3.11). Interdisciplinary professionals' perception of FCC did not significantly change pre‐and post‐implementation/COVID‐19 pandemic for respect (3.00–2.92), collaboration (3.22–3.33), support (3.20–3.20) and overall (3.15–3.20; 95% CI: 3.10–3.25). Conclusion: Despite the challenges of COVID‐19 restricting NICU access, the provision of FCC was maintained and even improved. Relevance to clinical practice: Further research is necessary to develop FCC practice innovations associated with communication, across diverse health care systems and resources. [ABSTRACT FROM AUTHOR]