Most newly diagnosed pediatric oncology patients begin their disease trajectory in the inpatient setting, but this initial hospitalization has become shorter as more care is provided in the outpatient setting. This creates a short timeframe for families to process the diagnosis, adapt to new roles, and acquire essential knowledge and care-management skills. Parents who feel inadequately prepared often struggle to care for their child at home; this might result in increased stress, poorer patient outcomes, and increased emergency department visits and readmissions.
Fortunately, there have been great strides in the progress of treating children diagnosed with cancer during the last 50 years, with ever-increasing survivor outcomes. This is what every practitioner working in the pediatric oncology field strives and hopes for. And yet, despite the remarkable and increasingly sophisticated treatment options, not all children will survive their diagnosis with cancer. In general, nurses have more training, education, and skills with delivering chemotherapy, biotherapy, and other interventions than in providing end-of-life care.
The inpatient hematology/oncology and stem cell transplant units at an urban children’s hospital had experienced multiple years above the Solutions for Patient Safety (SPS) baseline central line-associated bloodstream infection (CLABSI) rates, including and excluding mucosal barrier injury (MBI) events. Two clinical nurse specialists (CNSs)—one focused on hospital-acquired infections, another focused on the inpatient cancer center—decided to approach their local policies and outcomes data critically.