Welcome to the first Newsletter of 2025!
The iPOG Network wishes you all another successful year developing, adopting, adapting and implementing supportive care guidance!
Nurse-Led Supportive Care Implementation
In November 2024, Dr. Diane Altounji, Children’s Hospital Los Angeles, USA and Ms. Jill Shergold, Queensland Children’s Hospital, shared their experiences with guideline implementation with the Network.This presentation highlighted how nurse-led clinical inquiry and involvement in evidence-based practice implementation empowers nurses and improves patient outcomes. We encourage you to watch the entire webinar on the iPOG Network’s YouTube channel. A brief summary of this presentation follows:
Reducing CLABSI through an Oral Care and Hygiene Bundle
At Children’s Hospital Los Angeles (CHLA), the Johns Hopkins Evidence-Based Practice Model was used as a tool to determine best practices for decreasing central line-associated bloodstream infections (CLABSIs) in children with cancer. The process began with a nurse-led team identifying the practice question: “In pediatric oncology patients, what type of oral care is most effective in prevention of mucosal barrier injury (MBI) CLABSIs?” The team was aware that the Pediatric Oncology Group of Ontario guideline on mucositis supported good oral hygiene, which led to further search and appraisal of evidence regarding oral hygiene best practices. A thorough search of evidence was conducted, the evidence was appraised, and recommendations were developed based on evidence synthesis. The final recommendation resulted in the creation of an oral care bundle and CLABSI prevention strategies. The team decided that all strategies should be combined as an overall hygiene bundle to further improve patient outcomes.
The team presented the bundle to all necessary stakeholders with a translation and outcome evaluation plan prepared. Staff and patient/family education was completed to ensure that all understood the rationale and clinical impact of the bundle. Incorporating this important change management technique was imperative to ensure compliance. Once the bundle was implemented, the project team compared pre and post intervention CLABSI rates. In 2014, pre-implementation laboratory confirmed bloodstream infections (LCBI) CLABSIs were 1.05/1000 catheter days, and MBI CLABSIs were 2.98/1000 catheter days. In 2018, post-implementation LCBI CLABSIs were 0.54/1000 catheter days, and MBI-CLABSIs were 1.27/1000 catheter days. The year-to-date 2024 rates are 0.22/1000 catheter days for LCBI CLABSIs and 0.77/1000 catheter days for MBI CLABSIs.
Chemotherapy-Induced Vomiting Guideline Implementation
The first antiemetic policy for the Royal Children’s Hospital in Brisbane was developed over 20 years ago by a nurse in collaboration with a multidisciplinary team. Prior to this policy, the hospital lacked a consistent approach to chemotherapy-induced nausea and vomiting (CINV) management. Cost of antiemetics prompted the desire to standardize our approach to controlling CINV based on the current evidence. In collaboration with members of the multi-disciplinary team, the team created a local policy by benchmarking with other pediatric sites, identifying published clinical practice guidelines and reviewing the literature. Interprofessional education was provided, and the recommendations were incorporated into our hospital’s Guide to Chemotherapy. There are many other examples of nursing-led supportive care projects that change practice.
November 2024 Webinar Audience
People from 11 countries (Australia, Belgium, Canada, Germany, Ghana, Mexico, Netherlands, Philippines, Spain, Uganda, USA) attended the webinar and many more have watched the recording on our YouTube channel.
iPOG Network’s sub-Committee Updates
The iPOG Network recently re-organized under a sub-committee structure. Brief descriptions of the focus of each sub-committee follow:
Guideline Resource sub-Committee (co-Chairs: Dr. Jason Freedman, MASCC, Dr. Paula Robinson, POGO) We will continue to discuss our sub-Committee’s scope and focus. In general, the sub-Committee will promote and optimize guideline development and implementation. We will identify and share guideline resources and best practices including guideline development methods and implementation tools.
Membership sub-Committee (Chair: Dr. Yin Ting Cheung, MASCC): We play a crucial role in expanding the network of healthcare organizations, professionals, and advocates in the field of supportive care in pediatric oncology. By identifying strategies to recruit organizations and members from various backgrounds and geographical regions, our primary aspiration is to foster a diverse and inclusive community that shares knowledge, resources, and evidence-based practices in supportive care.
Mentorship sub-Committee (Chair: Dr. Paula Robinson, POGO): We are continuing to discuss the role of the sub-Committee. The initial focus of the sub-Committee will likely be on providing mentorship opportunities on implementation of supportive care CPG recommendations into healthcare practice.
Keep an eye out for:
– An announcement for our next webinar slated to be held in late February or early March – date and topic will be communicated shortly!
– Upcoming guidance published by iPOG Network member organizations:
- Food restrictions for pediatric cancer patients
Keep up with the iPOG Network’s activities including late-breaking publications of new guidance, new webinars and more by following us on “X” and “LinkedIn”
Want to get involved in the work of the iPOG Network?
Email us at ipog.network@gmail.com