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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., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the University of Queensland (# 2023/HE000076). This research conducted in accordance with the Declaration of Helsinki. All included study participants consented to participating in this study and to have their survey responses published in a peer reviewed journal. Conflict of interest: The authors have no competing interests to declare that are relevant to the content of this article., (© 2025. The Author(s).)

Background: The COVID-19 pandemic affected the maternal-infant dyad, especially due to visitation restrictions in neonatal units. These changes may impact the psychological, physical, and developmental health of mothers and newborns., Purpose: This systematic review evaluates the impact of enforced separation and restrictive visitation policies in neonatal units during the pandemic, focusing on the maternal-infant dyad., Data Sources: Data sources include CINAHL, MEDLINE, Web of Science, APA PsycINFO, Academic Search Ultimate, and Embase, covering studies published between 2020 and 2024., Study Selection: A detailed search was conducted using terms related to COVID-19, maternal and neonatal health, and visitation restrictions in neonatal units. Articles were included if they were peer-reviewed, written in English, and focused on the impact of visitation restrictions on maternal and neonatal health., Data Extraction: The data extraction process began with 789 references. After removing duplicates, we screened titles and abstracts. We then conducted a full-text assessment of the remaining studies, selecting 14 that met the inclusion criteria., Results: The analysis showed significant emotional, psychological, and developmental impacts on mothers and newborns due to pandemic-induced separation and inconsistent policies. It highlighted depressive symptoms, stress, bonding disruptions, and the effectiveness of virtual bonding., Implications for Practice and Research: The review emphasizes the need for family-centered care, coping strategies, and virtual bonding in neonatal units. It calls for culturally sensitive policies to support mothers and infants during crises. The review also highlights the importance of studying the long-term effects of pandemic-induced separations and improving support for future health emergencies., (Copyright © 2024 by The National Association of Neonatal Nurses.)

Background: Implementing family-centered care (FCC) presents challenges to parental-healthcare provider partnership and collaboration in newborn care in neonatal intensive care units (NICUs)., Aims: To explore NICU nurses' perceptions of FCC (respect, collaboration, and support) during the COVID-19 pandemic and to compare these between nurses working in secondary and tertiary/higher care settings., Methods: A multicenter, cross-sectional exploratory online survey design study was conducted to identify Thai NICU nurses' perceptions. The online survey of the Perceptions of Family-Centered Care-Staff (PFCC-S) was distributed via a Web page and professional networks between July and September 2022., Results: Of the 187 survey respondents, most NICU nurses worked in the NICU for less than 16 years and were employed in tertiary care/higher care settings in southern Thailand. There was a significant difference in perceptions of support subscale between NICU nurses in secondary (mean: 3.32, SD ± 0.53) and tertiary/higher care settings (mean: 3.17, SD ± 0.46) (P < .05)., Conclusion: Despite the challenges of the visitation restriction of COVID-19 in Thailand, nurses' perceptions of the value of FCC were maintained., Relevance to Clinical Practice: Further research is recommended to investigate how FCC can be implemented where there is a lack of material and infrastructure resources and staff shortage., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

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., (© 2021 British Association of Critical Care Nurses.)

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., (© 2022 The Authors. Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)