Tricia Kleidon

Tricia Kleidon
Griffith University · Centre for Health Practice Innovation

B Health Science (Nursing), Grad. Cert. Paediatrics, M Nursing Science (Nurse Practitioner)

About

54
Publications
17,405
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544
Citations
Citations since 2016
47 Research Items
529 Citations
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2016201720182019202020212022050100150
2016201720182019202020212022050100150
2016201720182019202020212022050100150

Publications

Publications (54)
Article
Background: Central venous access devices (CVADs) are integral to cancer care provision. Despite the high prevalence of CVAD complications in children with cancer, preventative strategies are understudied. Objective: The aim of this study was to assess study feasibility, occlusive events, thrombolytic use, adverse events, and direct costs of cat...
Article
Full-text available
Objectives The aim of this study was to examine patient perceptions regarding vascular access quality measurement.MethodsA web-based, cross-sectional survey was performed using a convenience sample of healthcare consumers with vascular access experience, recruited from September 2019 to June 2020. Survey respondents were asked to rate the perceived...
Article
Full-text available
Objective To determine the incidence of adverse events (AEs) associated with umbilical catheters in the neonatal population. Study design Systematic review and meta-analysis of observational studies and randomized controlled trials published between 2010 and 2020. Results In total 14,226 umbilical venous catheters (UVCs) and 4228 umbilical arteri...
Article
Background Peripheral intravenous catheters are an essential medical device which are prone to complications and failure. Objectives Identify patient, provider and device risk factors associated with all-cause peripheral intravenous catheter failure as well as individual complications: phlebitis, infiltration/occlusion, and dislodgement to improve...
Article
Introduction Adverse events associated with umbilical catheters include malposition, bloodstream infections, thrombosis, tip migration, and extravasation, resulting in loss of vascular access and increased risk of morbidity and mortality. There is a need for greater understanding of risk factors associated with adverse events to inform safe practic...
Article
Objective: To examine the effectiveness of antimicrobial and antithrombogenic materials incorporated into peripherally inserted central catheters (PICCs) to prevent bloodstream infection, thrombosis, and catheter occlusion. Methods: Prospective cohort study involving 52 hospitals participating in the Michigan Hospital Medicine Safety Consortium....
Article
Full-text available
Introduction Peripherally inserted central catheters (PICCs) are vital for the delivery of medical therapies, but up to 30% of PICCs are associated with complications such as deep vein thrombosis or infection. The integration of antimicrobial and hydrophobic catheter materials, and pressure-activated valves, into polyurethane PICCs are innovations...
Article
Full-text available
Background: Data regarding vascular access device use and outcomes are limited. In part, this gap reflects the absence of guidance on what variables should be collected to assess patient outcomes. We sought to derive international consensus on a vascular access minimum dataset. Methods: A modified Delphi study with three rounds (two electronic s...
Article
Aim Central venous access devices (CVADs) are vital medical devices to support the treatment of paediatric cancer; however, device occlusion is common, which disrupts treatment. This study aimed to improve the identification and management of CVAD occlusions in children with cancer, as well as to identify the demographic, clinical and device charac...
Article
Full-text available
Pilot randomized controlled trial (180 patients) of needleless connector decontamination. Central line-associated bloodstream infection occurred in 2% (1/61) of 70% isopropyl alcohol (IPA) wipe, 2% (1/59) of 70% IPA cap, and zero (0/58) infections in 2% chlorhexidine gluconate in 70% IPA wipe patients. Larger definitive trials are feasible and need...
Article
Background: Peripherally inserted central catheters are susceptible to microbial colonisation and subsequent biofilm formation, leading to central line-associated bloodstream infection, a serious peripherally inserted central catheter-related complication. Next-generation peripherally inserted central catheter biomaterials, such as hydrophobic mat...
Article
Full-text available
Objectives: To describe the methodology undertaken to provide guidance on the appropriateness, as well as inappropriateness, of vascular access device selection, characteristics, and insertion technique for pediatric patients. Methods: The RAND Corporation-University of California, Los Angeles Appropriateness Method was used. After definition of...
Article
Full-text available
Objectives: Vascular access device decision-making for pediatric patients remains a complex, highly variable process. To date, evidence-based criteria to inform these choices do not exist. The objective of the Michigan Appropriateness Guide for Intravenous Catheters in pediatrics (miniMAGIC) was to provide guidance on device selection, device char...
Article
Aim Evaluate the feasibility of an efficacy randomised control trial (RCT) of paediatric peripheral intravenous catheter (PIVC) securement to prevent failure without resultant skin damage. Methods A 3-arm, pilot RCT in an XX paediatric hospital. Random assignment of 330 children to receive (i) bordered polyurethane dressing (BPU) + non-sterile foa...
Article
Full-text available
Background: A vascular access registry is a key strategy proposed to improve patient safety and quality, but its impact will be shaped by the attitudes, experience and resources of end-user stakeholders. This study aimed to examine stakeholders’ perspectives and experiences regarding the feasibility and utility of a standardized platform to collect...
Article
Background High-quality paediatric nursing research is needed to inform and advance nursing practice. To date there has not been a systematic description of the current state of Australian paediatric nursing research. Aim The aim of this study was to identify and describe demographic, professional, and research characteristics of Australian nurses...
Article
Purpose: To describe worldwide characteristics, performance and risk factors of peripheral intravenous catheters (PIVCs), in pediatrics. Design: A secondary, subgroup analysis of pediatric (<18 years) data was undertaken, using a global, cross-sectional study of PIVCs. Practice characteristics included: demographic, diagnostic, utility, manageme...
Article
Background: Peripheral venous cannulation is considered a routine procedure, yet 50% of first attempt insertions fail, necessitating repeat insertion attempts. Identification of children with difficult intravenous access (DIVA) can help promote prompt escalation to an appropriately skilled clinician. Objective: To describe current international...
Article
Aim: To describe practice evolution, complications and risk factors for multiple insertion attempts and device failure in paediatric central venous access devices (CVADs). Methods: A paediatric retrospective cohort study using prospectively collected data from CVAD database 2012-2014. Data included were patient (i.e. age, condition), insertion (...
Chapter
Full-text available
Venous access is one of the most basic yet critical components of patient care in both inpatient and ambulatory healthcare settings. Safe and reliable venous access is vital to patients and their families to ensure timely and complication-free treatment. Obtaining reliable access in the pediatric patient can be challenging due to various factors in...
Chapter
Full-text available
A high-quality vascular access practice is of utmost importance in the area of pediatrics to ensure the preservation of vessel health. Pediatric clinicians must ensure that a focus on vessel health and preservation is evident from the child’s earliest exposure to healthcare. The ability to ensure long-term vessel health and preservation from infanc...
Chapter
Full-text available
Maintaining function throughout the VADs therapeutic dwell requires the use of effective post-insertion care strategies. Some aspects of post-insertion VAD management can be appropriately generalized from adult literature, and this has already been summarized in Chaps. 10.1007/978-3-030-03149-7_10–10.1007/978-3-030-03149-7_12. This includes the imp...
Chapter
Full-text available
Achieving vascular access in infants and pediatrics can be physically and emotionally challenging; therefore, every attempt to mitigate unnecessary venous access should be considered. The Infusion Nursing Standards of Practice recommends that, after assessment of all pertinent factors, the least invasive device to facilitate the prescribed treatmen...
Article
Central venous access devices (CVADs) are vital to enable treatment for children with cancer and other complex health conditions. However, complications effecting the CVAD wound are commonly reported. This study aimed to identify the incidence and prevalence of CVAD-associated skin complications current management, and characteristics associated wi...
Article
Aim To test the feasibility of an efficacy trial comparing different flushing frequencies and volumes to reduce peripheral intravenous cannula (PIVC) failure in paediatric inpatients. Methods Pilot, 2 × 2 factorial, randomised controlled trial comparing PIVC flushing techniques in intervention pairs: (i) low volume (3 mL) versus high volume (10 mL...
Article
Full-text available
Aim To improve paediatric peripheral intravenous catheter (PIVC) care through the implementation of care bundles. Methods A pre–post study using mixed methods (clinical audit, staff survey, parent interviews) in 2016 at a tertiary paediatric hospital in Brisbane was conducted to evaluate the effectiveness of a PIVC insertion and maintenance bundle...
Article
Background: Internationally, there is a lack of comparative vascular access (VA) data for pediatric clinicians and organizations to benchmark outcomes, evaluate quality initiatives, and improve practice. A VA registry is needed to address these knowledge and data capture gaps. Objectives: To determine the range and heterogeneity of VA outcome me...
Article
Full-text available
Background The reported incidence of peripheral intravenous catheter (PIV) failure has been as high as 69%. This is in part due to inadequate stabilisation or securement to the skin, which allows micro-motion of the catheter within the vein. Methods A pilot open randomised controlled trial of 300 patients was conducted in the medical and surgical...
Article
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This study describes a successful, targeted intervention in central venous access device routine care, to decrease central line associated bloodstream infection (CLABSI). Taurolidine-Citrate locks significantly reduced the rate of CLABSI, particularly Gram negative organisms without adverse events.
Article
Full-text available
Background: Despite the popularity of peripherally inserted central catheters (PICCs), recent literature highlights their potential injurious complications. Innovative PICC materials have been developed to prevent thrombosis and infection formation (Endexo®) and antireflux valves to prevent occlusion (pressure-activated safety valve®). No large ra...
Article
Purpose: To evaluate feasibility of an efficacy trial comparing peripherally inserted central catheter (PICC) dressing and securement techniques to prevent complications and failure. Materials and methods: This pilot, 3-armed, randomized controlled trial was undertaken at Royal Children's Hospital and Lady Cilento Children's Hospital, Brisbane,...
Article
Full-text available
Background Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate...
Article
Central venous access devices (CVADs) form an important component of modern paediatric healthcare, especially for children with chronic health conditions such as cancer or gastrointestinal disorders. However device failure and complications rates are high. Over 2½ years, a child requiring parenteral nutrition and associated vascular access dependen...
Article
Introduction Around 30% of peripherally inserted central catheters (PICCs) fail from vascular, infectious or mechanical complications. Patients with cancer are at highest risk, and this increases morbidity, mortality and costs. Effective PICC dressing and securement may prevent PICC failure; however, no large randomised controlled trial (RCT) has c...
Article
Nurses insert and care for more than two billion intravascular (IV) devices globally each year. A wound is created for each IV insertion, and the wound cannot heal while the IV remains.
Article
Aim: To identify the prevalence, management and complications associated with central venous access devices (CVADs) within Australian paediatric facilities, providing a map for clinicians, researchers and managers to focus solutions. Methods: A point prevalence audit and survey of CVAD practices in Australian tertiary paediatric hospitals between S...
Article
Full-text available
Introduction Paediatric central venous access devices (CVADs) are associated with a 25% incidence of failure. Securement and dressing are strategies used to reduce failure and complication; however, innovative technologies have not been evaluated for their effectiveness across device types. The primary aim of this research is to evaluate the feasib...
Article
Full-text available
Introduction:Central venous access devices (CVADs) provide essential and reliable vascular access, but infection is a common and serious complication with paediatric patients. CVAD bundles have been demonstrated to effectively reduce central line-associated bloodstream infections (CLABSI), but primarily during CVAD insertion. Another emerging strat...
Article
Full-text available
Complications and failure of intravascular devices place significant burden on nursing workloads, patient outcomes and the health care system. The development and implementation of evidence to improve clinical practice surrounding the insertion and management of intravascular devices is an ongoing challenge to which nurse practitioners (NPs) in vas...
Article
Objective Children admitted to hospital commonly require peripheral intravenous catheters (PIVCs) for treatment. This study sought to address a gap in the literature about current practice in the securement and dressing of PIVCs in paediatric acute care, and to ascertain the duration and failure of these devices.MethodsA prospective cohort study co...
Article
Many of the risks associated with central venous access are well recognized. We report a case of inadvertent lymphatic disruption during the insertion of a tunneled central venous catheter in a patient with raised left and right atrial pressures and severe pulmonary hypertension, which led to significant hemodynamic instability. To our knowledge, t...
Conference Paper
PURPOSE To evaluate the technical success and complications of placement of central venous port devices by a pediatric interventional radiology team. METHOD AND MATERIALS This is a prospective study of procedures performed between October 1999 and March 2005. A suitable vein was punctured using sonographic guidance and fluoroscopy was used to inse...
Article
Static electricity within sterile packaging may result in bacterial contamination of central venous catheters (CVCs) prior to insertion. To prevent this, some surgeons inject saline into the pack before opening it. This trial was designed to determine the effect of this procedure. A double blind randomised controlled trial of 47 CVCs comparing inje...
Article
Image-guided central venous access is forming an increasingly large proportion of the workload in interventional radiology following recognition that such techniques are less invasive and often quicker than traditional surgical techniques, with clear benefit in subjects with multiple previous attempts at venous access. Venous access sites are gener...

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