Red cell transfusions in children with thalassemia: Outcomes of a10 mL/kg/h infusion rate

Children with transfusion-dependent thalassemia have an impaired ability to synthesize alpha or beta globin, which results in anemia. Packed red blood cell (PRBC) transfusions are required to increase hemoglobin, which supports appropriate growth and development. PRBC transfusions must be completed within 4 h; however, infusion rates vary across institutions. Our institution infuses PRBCs up to 10 mL/kg/h. A descriptive study of 21 children who received a total of 276 transfusions during 2021 demonstrated that this rate is safe and well tolerated. Shorter transfusion times support patients' and families' time, resources, and quality of life and aptly utilize institutional resources.

Functional Integration of Nursing Research Into a Pediatric Oncology Cooperative Group: Finding Common Ground

PURPOSE/OBJECTIVES

To provide a brief description of the historic role of nursing and nursing research in the culture of previous pediatric oncology cooperative groups and compare the research language used in cooperative groups with the language used in nursing research.

DATA SOURCES

Published empirical, clinical, and methodologic reports.

DATA SYNTHESIS

The culture and language of nursing research differ from those of medical research and the pediatric oncology cooperative group, the Children's Oncology Group (COG). Different approaches exist to integrate nursing research priorities into the priorities of COG, including freestanding protocols, companion protocols, and research objectives included in therapeutic protocols.

CONCLUSIONS

Full integration of nursing research into COG is feasible but dependent on recognition of cultural and language differences among researchers. Integration will be demonstrated by the number of concepts and protocols contributed to or developed by active nurses in COG.

IMPLICATIONS FOR NURSING

Significant advances exist for nurses conducting research in COG. These research efforts are facilitated by a familiarity with the science language used by other disciplines in COG and an understanding of COG's research processes. Increased interdisciplinary scientific collaborations involving nurses in COG particularly benefit pediatric patients with cancer.

Three instruments to assess fatigue in children with cancer: the child, parent and staff perspectives

The purpose of this study was to develop and test three instruments to measure fatigue in children with cancer from the perspectives of the child, parents and staff. The study consisted of three phases: instrument development, content validation, and estimations of psychometric properties of the three fatigue instruments. One hundred forty-nine children between the ages of 7-12 years presently receiving chemotherapy for cancer, 147 parents and 124 staff participated in this study. The instruments demonstrated strong initial validity and reliability estimates. This study is the first to provide valid and reliable instruments to measure fatigue in children with cancer.

Pain management for the child with cancer in end-of-life care: APON position paper

Although there have been major advances in the treatment of childhood cancer with an overall survival rate of more than 70%, cancer continues to be the leading cause of death in children resulting from disease. In 1998, 2,500 children in the United States died of cancer-related causes. Each year cancer kills more children than asthma, diabetes, cystic fibrosis, congenital anomalies, and acquired immunodeficiency syndrome combined. The Association of Pediatric Oncology Nurses (APON) is the leading professional organization for nurses caring for children and adolescents with cancer and their families. The highest standards of nursing practice are achieved through education, research, certification, advocacy, and affiliation. It is the position of APON that pain in the child dying of cancer can be effectively managed. This can be accomplished by making the prevention and alleviation of pain a primary goal, partnering with the patient and parents, and aggressively using appropriate pharmacologic and non-pharmacologic interventions. The pediatric oncology nurse has an essential role in the child's pain management at the end of life through nursing assessment, identifying expected outcomes, and performing and evaluating interventions.

Recombinant tissue plasminogen activator for central venous access device occlusion

Maintaining and restoring the function of central venous access devices (CVAD) is an important component of pediatric oncology nursing care. Until 1999, Abbokinase Open Cath (urokinase; Abbott, Abbott Park, IL), a thrombolytic agent was the product primarily used to resolve thrombotic occlusions in intravascular devices. Changes in the manufacturing process mandated by the FDA have resulted in a lack of availability of Abbokinase Open Cath. Recombinant tissue plasminogen activator (TPA) has provided an alternative solution for clearing occluded intravascular devices. This article reviews the literature supporting the use of TPA for CVAD clearance and discusses the process of how to administer the medication. Future implications for research about the use of TPA, and its role in the care of CVADs are discussed.