Publications by authors named "Ullman A"
Background: New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.
Methods: We conducted a randomized, controlled, superiority trial in three Australian tertiary hospitals.
Article Synopsis
- The review emphasizes the need for equitable access to clinical trials for children from Indigenous and diverse backgrounds, which should be a priority in trial design.
- A systematic search of clinical trials conducted in Australia between 2018 and 2022 revealed that over 58% did not report important demographic variables like Indigenous status or ethnicity, highlighting significant gaps in data collection.
- The findings suggest implementing clear reporting standards and encouraging self-identification to improve demographic data collection, which is crucial for fostering health equity and safety in clinical trials involving children.
Objective: To explore current practice and guidelines surrounding the identification and management of extravasation injuries in Australian and New Zealand neonatal and pediatric settings.
Methods: Between February and September 2023, an internet-based descriptive cross-sectional survey was distributed to Australian and New Zealand neonatal and pediatric clinicians using exponential nondiscriminative snowball sampling. Survey data domains included demographics, extravasation identification, management, local guidelines, and resources.
As wearable biosensors are increasingly used in healthcare settings, this review aimed to identify the types of wearable biosensors used for neonate and pediatric patients and how these biosensors were clinically evaluated. A literature search was conducted using PubMed, CINAHL, Embase, Web of Science, and Cochrane. The studies published between January 2010 and February 2024 were included.
View Article and Find Full Text PDFPurpose: Patients receiving treatment for solid tumours and haematological malignancies, among other acute and chronic health conditions, are highly dependent upon central venous access devices (CVADs) for administering chemotherapy and other complex therapies; thus, CVADs can meaningfully impact their health outcomes and experiences. This systematic review aimed to identify and critique patient-reported outcome measure (PROM) and patient-reported experience measure (PREM) instruments related to CVADs.
Methods: A systematic review was undertaken, commencing with an electronic search of health databases (April 2022).
Aim: This scoping review aims to expansively review the reporting of Indigenous status, ethnicity, culture, language and country of birth in Australian paediatric clinical studies.
Methods: Scoping review of Australian clinical studies, including randomised controlled trials, non-randomised controlled trials, cluster randomised controlled trials and quasi-experimental studies, with paediatric participants (<18 years) or mixed adult and paediatric participants. PubMed, Cumulated Index to Nursing and Allied Health Literature and Embase databases were searched for clinical studies published 1 January 2018 to 28 November 2022.
Unlabelled: Neonates often require vascular access devices for medication or fluid therapy, but a third of devices fail before treatment completion or end with a complication. For adults and children, securing these devices with tissue adhesive (TA) increases the dwell and reduces complications. However, there is a lack of evidence for the neonatal population.
View Article and Find Full Text PDFAim: To provide a contemporaneous evidentiary overview of neonatal and paediatric studies investigating alarm-related patient safety and alarm system management. Furthermore, to describe how clinical alarm burden is captured and reported, to identify clinical devices that contribute to alarm burden, to explore alarm-related and patient safety measures and terminologies and to review alarm management initiatives.
Design: Scoping review.
Background: Preoperative fasting is the standard of care for patients undergoing a procedure under general anaesthesia. Despite the increased leniency of fasting guideline recommendations, prolonged preoperative fasting periods continue to disproportionally affect paediatric patients. This review maps existing interventions optimising paediatric fasting practices, to explore strategies that can be best applied in clinical practice.
View Article and Find Full Text PDFPurpose: To systematically review the proportion and incidence of CVAD-associated complications in pediatric patients with cancer.
Methods: PubMed, Embase, and the Cumulative Index of Nursing and Allied Health Literature were searched from 2012 to 2022. Cohort studies and the control arm of randomized controlled trials, which reported CVAD-associated complications in pediatric patients aged 0-18 years, were included.
Article Synopsis
- The study aimed to evaluate if the I-DECIDED tool improves assessment and decision-making related to peripheral intravenous catheters in pediatric patients.
- Conducted as a quasi-experimental, interrupted time-series study in a Brazilian hospital, data was collected from patients under 15 years old with intravenous catheters across three pre- and three post-intervention time points.
- Results showed significant improvements after using the I-DECIDED tool, including reduced complications, better dressings, and increased awareness and documentation among patients, families, and healthcare providers.
Background: An evidence and consensus-based instrument is needed to classify central venous access device-associated skin impairments.
Aim: The aim of this study was to design and evaluate the central venous access device-associated skin impairment classification tool.
Design: A two-phase modified Delphi study.
Aim: To explore the barriers and facilitators influencing emergency department clinicians' adherence to the Australian Peripheral Intravenous Catheter (PIVC) Clinical Care Standard, using the Behaviour Change Wheel (BCW).
Background: Suboptimal PIVC practices are frequently linked to a range of patient-important adverse outcomes. The first Australian Peripheral Intravenous Catheter Clinical Care Standard was introduced in 2021, aiming to standardize practice.
Article Synopsis
- The study investigates how different settings and strategies affect the selection of alternative materials and designs for peripherally inserted central catheters (PICC).
- Qualitative interviews were conducted with 23 stakeholders, revealing key themes such as the importance of intervention adaptability, staff involvement, and adequate funding in successfully implementing changes.
- Ultimately, while trial evidence is vital, the research emphasizes the need to consider local healthcare contexts and resources when making decisions regarding PICC materials and designs.
Introduction: Peripheral intravenous catheters (PIVCs) are the most commonly used vascular access device in hospitalised patients. Yet PIVCs may be complicated by local or systemic infections leading to increased healthcare costs. Chlorhexidine gluconate (CHG)-impregnated dressings may help reduce PIVC-related infectious complications but have not yet been evaluated.
View Article and Find Full Text PDFImportance: Catheter dislodgement is a common complication for children with tunneled or peripherally inserted noncuffed central venous catheters (CVCs). A subcutaneous anchor securement system (SASS) may reduce this risk compared with traditional adhesive securement.
Objective: To compare dislodgement of noncuffed CVCs secured with SASS with dislodgement of noncuffed CVCs secured with sutureless securement devices (SSDs).
Article Synopsis
- * A two-arm randomized controlled trial will be conducted across seven hospitals in Australia and New Zealand to compare the effectiveness of T-EDTA versus saline solutions in reducing CVAD-related adverse events, with a plan to recruit 720 participants.
- * The study has received ethical approvals from relevant committees and will adopt a mixed-methods approach to understand the implementation experiences from the perspectives of both clinicians and healthcare purchasers.
Background: Peripherally inserted central catheters (PICCs) facilitate diagnostic and therapeutic interventions in health care. PICCs can fail due to infective and non-infective complications, which PICC materials and design may contribute to, leading to negative sequelae for patients and healthcare systems.
Objectives: To assess the effectiveness of PICC material and design in reducing catheter failure and complications.
Background: Central venous access devices (CVAD) are associated with central line associated bloodstream infection (CLABSI) and venous thromboembolism (VTE). We identified trends in non-intensive care unit (ICU) CVAD utilization, described complication rates, and compared resources between low and high CVAD sites.
Methods: We combined data from the Pediatric Health Information System (PHIS) database and surveys from included hospitals.
Article Synopsis
- The PiccPed® health application was created to help nurses make better clinical decisions about managing peripherally inserted central catheters (PICCs) in pediatric and neonatal patients.
- A study involving 56 nurses showed that using the app significantly improved their knowledge on preventing PICC-related complications, with those who used it more gaining the most benefit.
- The findings suggest that the PiccPed® app is an effective tool for ongoing training and education for nurses working with children and neonates who require PICC care.
Unlabelled: Paediatric patients with complex or acute conditions may require a central venous access device, however, almost one-third of these devices have associated complications (e.g. infections).
View Article and Find Full Text PDFBackground: Peripheral arterial catheters (ACs) are used in anaesthesia and intensive care settings for blood sampling and monitoring. Despite their importance, ACs often fail, requiring reinsertion. Dressings and securement devices maintain AC function and prevent complications such as infection.
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