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Changing Catheter Locking Solutions in Paediatric Cancer Care: What Gets in the Way (and What Helps)

Posted on 7 July 2026
Changing Catheter Locking Solutions in Paediatric Cancer Care: What Gets in the Way (and What Helps)
Study Overview

In paediatric oncology, central venous access devices (CVADs) are essential, but complications like occlusion and infection can disrupt treatment and cause significant harm. While alternative catheter locking solutions show promise, changing routine practice across hospitals is rarely straightforward.

This study explored what it would take to implement an alternative catheter locking solution in paediatric cancer care. Researchers conducted semi-structured interviews with clinicians and decision makers across four Australian hospitals (23 participants). Using an implementation science approach, they identified key barriers and enablers, matched them to practical implementation strategies, and estimated the cost of rolling those strategies out at a site level.

Key Findings
  • Barriers were mostly system- and workflow-related
    • The most common barriers were cost, infrastructure/work systems, communication gaps, limited networks/partnerships, variable motivation for change, and the realities of who delivers the practice day to day.
  • Implementation needs people, not just evidence
    • Strategies most likely to support change included building strong networks, appointing change champions, and securing funding to support rollout and sustainability.
  • The “strategy bundle” cost was estimated per site
    • The estimated total cost to implement the recommended strategy bundle was AUD $29,752 per site.

Implications

This paper reinforces a practical truth: even when an intervention is clinically promising, implementation can stall without the right supports. For paediatric oncology services considering a new catheter locking solution, success will likely depend on three things:
  • Funding and planning (so change isn’t “extra work with no support”)
  • Champions and coalitions (so the change is led, reinforced, and normalised)
  • Clear communication and alignment across sites (so practice stays consistent when patients move between services)

The benefit of this approach is that it makes implementation actionable and budgetable, helping services plan for real-world uptake rather than relying on goodwill alone.

Read more:https://doi.org/10.1016/j.ejon.2026.103216

Authors: Elouise R. Comber; Amanda J. Ullman; Victoria Gibson; Mari Takashima; Joshua Byr; Samantha Keogh

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