Background Children with intestinal failure (IF) require parenteral nutrition (PN) at home, delivered through a central venous catheter (CVC) to support growth. CVC‐related complications including infection, breakage, and blockage are the most common cause of readmission to the hospital. The objective of this study was to evaluate the use of instructional videos as part of the caregiver home PN–teaching program to reduce CVC‐related complications. Methods Caregivers of children with IF requiring home PN were surveyed to assess skill confidence and interest in instructional videos for skill acquisition. Videos were then created using a smartphone and free video‐editing software. Input from stakeholders (families, care providers) was incorporated in video production. Families were given access to the videos, and CVC‐related complications were compared for 2 years prior to and 1 year following video introduction with Welch t‐test analysis. Results After obtaining ethics approval, 11 caregivers were surveyed. Thirty percent reported feeling underconfident in their skills at the time of discharge. After viewing the videos, 100% of caregivers reported that these videos were useful. Catheter‐related complication rates significantly decreased in the year following the video introduction from 7.88 to 2.65 complications per 1000 catheter days (P = .046). This included reductions in catheter‐related infections, catheter occlusions, and breakages. Conclusions Children with IF receiving home PN are at high risk for CVC‐related complications, and caregivers are the first line of defense for catheter care. Instructional videos were low‐cost to create, were well received by all families, and may contribute to reduced catheter‐related complications.
Children who require surgical interventions are subject to physiologic stress, necessitating a period of healing when nutrition needs may temporarily change. Providing appropriate nutrition to children before and after surgery is an important part of minimizing surgical morbidity. There is a clear link between poor nutrition and surgical outcomes, therefore providing good reason for ensuring an appropriate nutrition plan is in place for children requiring surgery. This review will address recent research investigating nutrition considerations for pediatric surgical patients with a focus on practical tools to guide decision making in the preoperative, intraoperative, and postoperative periods.
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