Use of instructional videos to reduce central venous catheter complications in children with intestinal failure receiving home parenteral nutrition

Abstract

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.

Artificial Intelligence Algorithm-Based Computed Tomography Images in the Evaluation of the Curative Effect of Enteral Nutrition after Neonatal High Intestinal Obstruction Operation

“…Some research data show that early enteral nutrition for newborns with high intestinal obstruction through indwelling nasojejunal nutrition tube is effective, but the selection of milk products and the way of milk volume increase in the process of enteral nutrition are still in the exploratory stage, and the number of domestic relevant studies on the evaluation of their nutritional status is limited [21]. Studies suggested that there is a possibility of concurrent infection with indwelling nasojejunal nutrition [22], which may be different from this study and needs further research.…”

The impact of targeted interventions aimed to improve quality of life in patients receiving home parenteral nutrition: A systematic literature review

“…Four interventions utilised an interactive educational strategy focused on patients or carers. Two studies were RCT's 26,28 and two were retrospective pre‐post studies 25,27 . All studies focused on increased education around central line care, with one study also including videos on (i) prevention of depression and (ii) improving problem‐solving skills 28 .…”

“…Three studies demonstrated a significant decrease in CLABSI rates with the intervention, 25,27,28 whereas one study showed no difference in CLABSI or rehospitalisation 26 . Smith et al 28 also assessed patient's problem‐solving skills and reactive depression scores, with significant improvements in both at 6 months.…”

“…Intervention strategies included educational resource/ programs for patients receiving HPN (n = 3) 25,26,28 and carers (n = 1), 27 telemedicine (n = 2), 29,30 additional training for preparing infusion mixtures at home (n = 1), 31 MBCT (n = 1) 32 and a multi-approached intervention (n = 1). 33 Methodologies included randomised control trials (RCTs) (n = 3), 26,28,29 retrospective pre-post studies (n = 3), 25,27,30 prospective comparative studies (n = 2) 31,32 and prospective with retrospective baseline study (n = 1). 33 The majority of studies had a risk of bias rating of critical.…”

“…Two studies were RCT's 26,28 and two were retrospective pre-post studies. 25,27 All studies focused on increased education around central line care, with one study also including videos on (i) prevention of depression and (ii) improving problem-solving skills. 28 Outcome measures included CLABSIs and rehospitalisation, as well as patient's knowledge, depression and problem-solving skills.…”