Objective To explore the effective management method of venous-access port related blood infection in the children with hematopoietic stem cell transplantation.Methods A retrospective analysis investigated venous-access port related blood infection in the hematopoietic stem cell transplantation children who were admitted to the centre of hematology oncology,Beijing Children′s Hospital,Capital Medical University from June 2013 to June 2014.The Plan-Do-Check-Action (PDCA)cycle management approach was applied to find the fundamental cause of venous-access port related blood infection.The plan was made.The appropriate measures were taken on the transplantation children with implantable venous-access ports after July 2014,which was supervised and inspected.Finally,the experience was summarized.Results From July 2014 to July 2015 there were 26 transplantation children with implantable venous-access ports.No venous-access port related blood infection was found in the 26 children.Conclusions The PDCA cycle decreases the occurrence of venous-access port related blood infection in the transplantation children significantly.It is an effective method to improve nursing safety and quality management.

Objective To explore the main cause of displacement of peripherally inserted central catheters ( PICC) among pediatric patients with hematologic disease .Methods Eleven nurses and 10 children's parents received the questionnaire on the cause analysis of displacement of PICC among pediatric patients with hematological tumor which was made through the analytical hierarchy process theory , the literature review and interview.The weight of each indicator was calculated in the two groups , and the indicator was put in the right order according to their weights .Results The top 4 main causes agreed by nurses and parents in the displacement of PICC among pediatric patients with hematologic disease were respectively poor supervision C 6 , non-standard dressing methods C 1 , different adhesive forces of dressings C 15 , excessive activity of arm in where the PICC line was located C 9 , and the predominant reason was the poor supervision C 6 .Conclusions We should strengthen the training of nurses , and choose the appropriate dressings , and enhance the guard consciousness of the displacement of PICC in children's parents , and reinforce the supervision , and reduce the arm activity so as to decrease the displacement of PICC among pediatric patients with hematologic disease .

Objective:To retrieve, evaluate and integrate domestic and foreign relevant evidence on the prevention of oral mucositis related to chemoradiotherapy in children, and summarize the best evidence, so as to provide clinical practice guidelines for medical staff.Methods:We systematically searched the evidence on the prevention of oral mucositis related to chemoradiotherapy in children in British Medical Journal (BMJ) Best Practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-based Health Care Center Database, National Guideline Clearinghouse, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, United Kingdom National Institute for Health and Care Excellence, International Practice Guideline Registry Platform (Chinese) , Multinational Association of Supportive Care in Cancer, International Society of Oral Oncology, European Society for Medical Oncology, American Society of Clinical Oncology, Cochrane Library, BMJ Journals, PubMed, Embase, China National Knowledge Infrastructure (CNKI) , WanFang Data and China Biology Medicine Database. The evidence included clinical practice guidelines, expert consensus, best practices, systematic reviews and evidence summaries, and the search time limit was to build the database until November 1, 2019. The searched guidelines were independently evaluated by four guideline reviewers, and the rest of literature was independently evaluated by two researchers who received evidence-based training to evaluate the quality of the included literature, combined with the judgment of professionals. Evidence extraction and evidence summary were carried out on literature that met the quality standards.Results:A total of 8 articles were included, including 1 BMJ best practice, 5 JBI evidence summaries, 1 guideline, and 1 systematic review. The best evidence included 16 pieces of evidence in 7 areas of basic oral care, nursing evaluation, diet prevention, physical therapy, drug prevention, fungal infection prevention, and multidisciplinary team management.Conclusions:This study summarizes the best evidence for the prevention of oral mucositis related to chemoradiotherapy in children, and provides clinical practice guidelines for medical staff. Medical institutions should establish preventive measures for children's oral mucositis related to chemoradiotherapy based on the transformation of evidence-based evidence, and establish standardized multidisciplinary collaboration and nursing procedures to improve patient health outcomes.

Objective:To apply the best evidence for prevention of oral mucositis in children with hematopoietic stem cell transplantation (HSCT) to clinical practice and evaluate its efficacy.Methods:Evidence-based nursing method was applied to obtain the best evidence, the evidence quality review indexes were established and the obstacle factors were analyzed, and then the action strategy was constructed. Using the convenient sampling method, a total of 60 children who were admitted to HSCT ward of Beijing Children's Hospital of Capital Medical University and 14 nurses working in HSCT ward were selected as the research objects from August 2019 to October 2020. The children admitted from August 2019 to February 2020 were included in the control group, and children admitted from March to October 2020 were included in the experimental group, with 30 cases in each group. Children in the control group received routine preventive measures for oral mucositis, while children in the experimental group received preventive measures for oral mucositis constructed based on the best evidence. Before and after the application of the evidence, the nurses' knowledge of preventing oral mucositis in children with HSCT was investigated through self-developed test papers. The incidence of oral mucositis and parents' satisfaction with prevention measures for oral mucositis were compared between the two groups.Results:Evidence-based nursing practice used 10 pieces of evidence. The incidence of oral mucositis in the experimental group was 50% (15/30) , lower than 83% (25/30) in the control group, and the difference was statistically significant (χ 2=7.50, P < 0.05) . The score of satisfaction with for preventive measures of oral mucositis of parents in the experimental group was (4.96±0.05) , which was higher than (3.65±1.60) of the control group, and the difference was statistically significant ( t=-9.69, P<0.01) . After the application of the evidence, the score of nurses' knowledge of prevention of oral mucositis was (98.22±6.65) , which was higher than (78.72±12.03) before the application, and the difference was statistically significant ( t=5.30, P<0.01) . Conclusions:Management of oral mucositis in children with HSCT through evidence-based nursing practice can effectively reduce the incidence of oral mucositis in children, improve parents' satisfaction with prevention measures for oral mucositis and nurses' knowledge of prevention of oral mucositis.

Objective:To retrieve and summarize the best evidence for nursing of hematopoietic stem cell reinfusion in children.Methods:Clinical decisions, guidelines, recommended practices, evidence summaries, systematic reviews, and expert consensuses on nursing of hematopoietic stem cell reinfusion in children were searched in Chinese and English databases as well as related websites such as British Medical Journal (BMJ) Best Practice, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Joanna Briggs Institute Evidence-Based Health Care Center Database, UpToDate, CINAHL, Embase, PubMed, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to March 2023. Two researchers independently conducted literature quality evaluation, identified the included literature, extracted evidence item by item, and translated, organized and summarized the evidence.Results:A total of nine articles were included, including two clinical decisions, two expert consensuses, four guidelines, and one evidence summary. 24 pieces of evidence were summarized from six aspects, consisting of child preparation, stem cell preparation, item preparation, nursing during reinfusion, nursing after reinfusion, and evaluation and education.Conclusions:The best evidence for nursing of hematopoietic stem cell reinfusion in children involves a wide range of aspects. Managers, clinical medical and nursing staff should apply evidence based on specific medical situations in order to safely and reasonably perform hematopoietic stem cell reinfusion.