Areum Hyun

Background: People receiving in‐centre haemodialysis have distinct cultural care needs and preferences, and nurses are expected to respond to these. However, haemodialysis nurses' cultural competence and responsiveness are unknown. Objectives: To examine nurses' cultural competence and responsiveness when caring for people with diverse cultural characteristics. Design: An online cross‐sectional survey. Participants: Haemodialysis nurses from Australia and New Zealand ( n = 123), recruited through the Renal Society of Australasia and professional networks. Measurements: The 25‐item Cultural Competence Assessment instrument measured cultural awareness and sensitivity, and culturally responsive behaviours. Demographic characteristics were also collected. Results: Of 123 complete responses, overall cultural competence was high ( M = 5.09, SD = 0.76), particularly awareness and sensitivity ( M = 5.76, SD = 0.53), with significantly higher scores among those who had completed cultural awareness training ( p = 0.009). In contrast, culturally responsive behaviours were moderate ( M = 4.53, SD = 1.23), highlighting the gap between cultural competence and responsiveness. The lowest scoring areas were documentation of patients' cultural needs ( M = 3.88, SD = 2.02) and access to cultural learning resources ( M = 3.02, SD = 1.75), indicating limited supports. Qualitative findings reflected practices of culture care preservation and accommodation, with themes of cultural awareness and language differences highlighting barriers related to language and resources. Conclusions: High cultural competence does not necessarily translate into culturally responsive behaviour. Organisational supports, including guidance for documenting cultural needs, cultural assessment tools and accessible learning resources, may help strengthen culturally responsive haemodialysis care.

Purpose: This study aimed to explore current central vascular access device (CVAD) management practices in pediatric cancer care globally and compare practices across high-income and middle-income (i.e., upper middle-income and lower middle-income) countries. Methods: A descriptive cross-sectional international survey was conducted between May 2022 and December 2023. Clinicians involved in CVAD insertion/management for pediatric cancer patients were invited to participate through established clinical networks globally. The survey covered CVAD management practices, including dressings, securements, routine care, and maintenance procedures. Results: A total of 220 responses from 42 countries were received. Polyurethane dressings were most commonly used across all CVAD types (55–65/34.2–40.4). Bordered dressings were the primary securement method for all CVAD types (69–96/161, 42.9–59.6%). Routine practices varied, with 31/102 (30.4%) assessing CVADs hourly during infusion in high-income countries and 22 (37.3%) assessing every shift in middle-income countries. Heparin and normal saline were the commonly used solutions for flushing and locking. Chlorhexidine 2% in 70% alcohol was the predominant decontamination solution in high-income countries (64/102, 62.8%), while alcohol was more common in middle-income countries (22/59, 37.3%). Differences were observed between high-income and middle-income countries in the types of dressings, securements, and maintenance practices used. Conclusion: This study revealed significant variability in CVAD management practices for pediatric cancer care globally, particularly between high-income and middle-income countries. These findings highlight the need for standardized, evidence-based guidelines considering resource availability and contextual factors to improve CVAD management in pediatric oncology across diverse healthcare settings.

Background: Central venous access devices (CVADs) are crucial for treating children with cancer and blood disorders. However, international variations in CVAD practices may impact patient outcomes. This study aimed to explore current CVAD selection and insertion practices in paediatric cancer care globally. Methods: An international cross‐sectional survey was conducted among clinicians involved in CVAD insertion and management for paediatric cancer patients. Convenience snowball sampling was used with participants invited via established clinical trial networks and other associated networks. The survey explored CVAD selection, insertion techniques, and related practices across economic classifications (high‐income vs. other‐income [lower middle and higher middle income]). Results: Of 300 respondents from 42 countries who completed the demographic section of the survey, 220 (73.3%) reported using CVADs in their practice. There were more respondents with no CVAD access in other‐income countries ( n = 25; 21.7%) compared to high‐income countries ( n = 8; 4.3%). PICCs were predominantly inserted by nurses in other‐income countries ( n = 30; 50.9%) versus anaesthetists ( n = 49; 48%) and radiologists ( n = 48; 47.1%) in high‐income countries. Ultrasound guidance for PICC insertion was used less frequently in other‐income countries (45.8% [ n = 27] vs. 68.6% [ n = 70]). Device selection generally aligned with guidelines, but variations existed, particularly for long‐term use. Skin decontaminant choices also varied, with alternative formulations more common in other income countries. Conclusions: This survey reveals global disparities in CVAD practices for paediatric cancer care. Resource availability appears to influence device selection, insertion techniques and insertion‐related care practices. These findings highlight the need for context‐specific guidelines and increased research participation from resource‐limited settings to improve global equity in paediatric cancer care.

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. Descriptive statistics were used to present counts and percentages of types, locations, clinical evaluation methods, and their results. Seventy-nine studies were included. 104 wearable sensors and 40 devices were identified. The most common type of biosensor was optoelectrical sensors (n = 40, 38.5%), and used to measure heart rate (n = 22, 19.0%). The clinical evaluation was tested by a combination of validity (n = 68, 86.1%) and reliability (n = 14, 17.7%). Only two-thirds of the wearable devices were validated or reported acceptable reliability. The majority of the biosensor studies (n = 51, 64.5%) did not report any complications related to wearable biosensors. The current literature has gaps regarding clinical evaluation and safety of wearable biosensor devices with interchangeable use of validity and reliability terms. There is a lack of comprehensive reporting on complications, highlighting the need for standardized guidelines in the clinical evaluation of biosensor medical devices. Impact The most common types of biosensors in pediatric settings were optoelectrical sensors and electrical sensors. Only two-thirds of the wearable devices were validated or reported acceptable reliability, and more than half of the biosensor studies did not report whether they assessed any complications related to wearable biosensors. This review discovered significant gaps in safety and clinical validation reporting, emphasizing the need for standardized guidelines. The findings advocate for improved reporting clinical validation processes to enhance the safety of wearable biosensors in pediatric care.

BackgroundNurse Practitioners work independently and collaboratively within multidisciplinary teams to fill unmet service delivery needs. Despite strong evidence of the benefits of the nurse practitioner service model, organisational support for nurse practitioners varies in terms of resources and support from leadership and other healthcare professionals.AimsThe study aimed to explore healthcare practitioners' experiences of implementation of a NP service in a rural setting.MethodsSemi-structured interviews were conducted with ten healthcare practitioners to investigate their perspectives of a recently implemented NP service. Data were analysed inductively using thematic analysis.FindingsThemes emerged related to facilitating collaborative practice, person-centred continuity of care and positive health outcomes for the community. Challenges and limitations related to operational role clarity, scopes of practice and leadership.ConclusionHealthcare practitioners were mostly satisfied with the service however challenges caused tension. Change management principles provide a framework to strengthen the effective clinical alignment of the service.