Abstract：
Paediatric patients with complex or acute conditions may require a central venous access device, however, almost one-third of these devices have associated complications (e.g. infections). Implementation of evidence-based practices regarding central venous access devices can reduce and potentially prevent complications.
OBJECTIVE: This scoping review aimed to explore recent interventional research in CVAD management through an implementation lens.
METHODS: This scoping review used the Arksey and O\'Malley framework. Studies were included if they were written in English, published in 2012 to July 2023, involved children and were relevant to the study aims. Risk of bias was appraised by the Mixed Methods Appraisal Tool.
METHODS: Searches were undertaken in EMBASE, CINAHL (Ebsco), PubMed, Web of Science and Cochrane Library (CENTRAL).
RESULTS: Of the 1769 studies identified in a systematic search, 46 studies were included. Studies mostly focused on health professionals and central venous access device maintenance and had quantitative pre-post study designs. Adherence to implementation frameworks was lacking, with many studies employing quality improvement approaches. Implementation strategies were typically multipronged, using health-professional education, bundles and working groups. Bundle compliance and reductions in central line-associated bloodstream infections were the most featured outcomes, with most studies primarily focusing on effectiveness outcomes.
CONCLUSIONS: Translation of evidence-based practices to the clinical setting is difficult and current adoption of implementation frameworks (apart from \'quality improvement\') is limited. Implementation strategies are diverse and dependent on the local context, and study outcomes typically focus on the effectiveness of the physical intervention, rather than measuring the implementation effort itself.
UNASSIGNED: Future intervention research requires a more uniform and deliberate application of implementation frameworks and strategies.
CONCLUSIONS: Greater exploration of relationships between frameworks and strategies and implementation and service outcomes is required to increase understanding of their role in maximizing resources to improve health care. Adhered to best reporting guidelines as per PRISMA-ScR (Tricco et al., 2018).
UNASSIGNED: No patient or public contribution.
OBJECTIVE: This scoping review aimed to explore recent interventional research in CVAD management through an implementation lens.
METHODS: This scoping review used the Arksey and O\'Malley framework. Studies were included if they were written in English, published in 2012 to July 2023, involved children and were relevant to the study aims. Risk of bias was appraised by the Mixed Methods Appraisal Tool.
METHODS: Searches were undertaken in EMBASE, CINAHL (Ebsco), PubMed, Web of Science and Cochrane Library (CENTRAL).
RESULTS: Of the 1769 studies identified in a systematic search, 46 studies were included. Studies mostly focused on health professionals and central venous access device maintenance and had quantitative pre-post study designs. Adherence to implementation frameworks was lacking, with many studies employing quality improvement approaches. Implementation strategies were typically multipronged, using health-professional education, bundles and working groups. Bundle compliance and reductions in central line-associated bloodstream infections were the most featured outcomes, with most studies primarily focusing on effectiveness outcomes.
CONCLUSIONS: Translation of evidence-based practices to the clinical setting is difficult and current adoption of implementation frameworks (apart from \'quality improvement\') is limited. Implementation strategies are diverse and dependent on the local context, and study outcomes typically focus on the effectiveness of the physical intervention, rather than measuring the implementation effort itself.
UNASSIGNED: Future intervention research requires a more uniform and deliberate application of implementation frameworks and strategies.
CONCLUSIONS: Greater exploration of relationships between frameworks and strategies and implementation and service outcomes is required to increase understanding of their role in maximizing resources to improve health care. Adhered to best reporting guidelines as per PRISMA-ScR (Tricco et al., 2018).
UNASSIGNED: No patient or public contribution.
摘要：
复杂或急性病症的儿科患者可能需要中心静脉接入装置，然而,这些装置中几乎有三分之一具有相关的并发症(例如感染).实施关于中心静脉接入装置的循证实践可以减少并潜在地预防并发症。
目的：本范围综述旨在通过实施镜头探索CVAD管理中的近期干预研究。
方法：此范围审查使用了Arksey和O\'Malley框架。如果研究是用英语写的，2012年至2023年7月发表，涉及儿童，与研究目标相关。偏倚风险通过混合方法评估工具进行评估。
方法：在EMBASE中进行搜索，CINAHL(Ebsco),PubMed,WebofScienceandCochraneLibrary(CENTRAL).
结果：在系统搜索中确定的1769项研究中，纳入46项研究。研究主要集中在卫生专业人员和中心静脉接入装置的维护，并有定量的研究前后设计。缺乏对实施框架的遵守，许多研究采用质量改进方法。实施战略通常是多管齐下的，利用卫生专业教育，捆绑包和工作组。集束依从性和减少中央线相关血流感染是最有特色的结果，大多数研究主要关注有效性结果。
结论：将基于证据的实践转化为临床环境是困难的，并且目前实施框架的采用（除了“质量改进”）是有限的。实施策略多种多样,视当地情况而定,研究结果通常集中在物理干预的有效性上，而不是衡量实施工作本身。
■未来的干预研究需要对实施框架和策略进行更统一和深思熟虑的应用。
结论：需要更深入地探索框架和战略与实施和服务成果之间的关系，以加深对它们在最大限度地利用资源改善医疗保健方面的作用的理解。遵守PRISMA-ScR的最佳报告准则(Tricco等人。,2018)。
■没有患者或公众捐款。
目的：本范围综述旨在通过实施镜头探索CVAD管理中的近期干预研究。
方法：此范围审查使用了Arksey和O\'Malley框架。如果研究是用英语写的，2012年至2023年7月发表，涉及儿童，与研究目标相关。偏倚风险通过混合方法评估工具进行评估。
方法：在EMBASE中进行搜索，CINAHL(Ebsco),PubMed,WebofScienceandCochraneLibrary(CENTRAL).
结果：在系统搜索中确定的1769项研究中，纳入46项研究。研究主要集中在卫生专业人员和中心静脉接入装置的维护，并有定量的研究前后设计。缺乏对实施框架的遵守，许多研究采用质量改进方法。实施战略通常是多管齐下的，利用卫生专业教育，捆绑包和工作组。集束依从性和减少中央线相关血流感染是最有特色的结果，大多数研究主要关注有效性结果。
结论：将基于证据的实践转化为临床环境是困难的，并且目前实施框架的采用（除了“质量改进”）是有限的。实施策略多种多样,视当地情况而定,研究结果通常集中在物理干预的有效性上，而不是衡量实施工作本身。
■未来的干预研究需要对实施框架和策略进行更统一和深思熟虑的应用。
结论：需要更深入地探索框架和战略与实施和服务成果之间的关系，以加深对它们在最大限度地利用资源改善医疗保健方面的作用的理解。遵守PRISMA-ScR的最佳报告准则(Tricco等人。,2018)。
■没有患者或公众捐款。
