Effects of Classical Music Virtual Reality on Pediatric Healthcare Worker Compassion Fatigue.

OBJECTIVE: The aim of this study was to explore the impact of classical music virtual reality (VR) on burnout, secondary traumatic stress, anxiety, and capacity for developing caring relationships with patients among healthcare workers (HCWs). BACKGROUND: COVID-19 accentuated the importance of promoting the well-being of frontline workers. Efforts to address the mental health needs of HCWs are likely to positively impact patient outcomes. METHODS: Healthcare workers completed 3 sessions of VR. A Wilcoxon rank-sum test was used to compare premeasure versus postmeasure on the Professional Quality of Life (ProQOL), State Trait Anxiety Inventory, and Caring Ability Inventory. Analysis of variance was performed to identify associations between the intervention and differences in scores for each ProQOL domain. Bonferroni correction adjusted for multiple comparisons. Fisher's t test was used for categorical analysis. RESULTS: Seventy-one HCWs completed the study. There was a significant reduction in burnout after the experience, compared with baseline. CONCLUSIONS: This study provides evidence that classical music VR may reduce burnout in HCWs.

Intracerebroventricular Cerliponase Alfa for Neuronal Ceroid Lipofuscinosis Type 2 Disease: Clinical Practice Considerations From US Clinics.

BACKGROUND: Neuronal ceroid lipofuscinosis type 2 or CLN2 disease is a rare, autosomal recessive, neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 deficiency. Cerliponase alfa, a recombinant human tripeptidyl peptidase 1 enzyme, is the first and only approved treatment for CLN2 disease and the first approved enzyme replacement therapy administered via intracerebroventricular infusion. METHODS: A meeting of health care professionals from US institutions with experience in cerliponase alfa treatment of children with CLN2 disease was held in November 2018. Key common practices were identified, and later refined during the drafting of this article, that facilitate safe chronic administration of cerliponase alfa. RESULTS: Key practices include developing a multidisciplinary team of clinicians, pharmacists, and coordinators, and institution-specific processes. Infection risk may be reduced through strict aseptic techniques and minimizing connections and disconnections during infusion. The impact of intracerebroventricular device design on port needle stability during extended intracerebroventricular infusion is a critical consideration in device selection. Monitoring for central nervous system infection is performed at each patient contact, but with flexibility in the degree of monitoring. Although few institutions had experienced positive cerebrospinal fluid test results, the response to a positive cerebrospinal fluid culture should be determined on a case-by-case basis, and the intracerebroventricular device should be removed if cerebrospinal fluid infection is confirmed. CONCLUSIONS: The key common practices and flexible practices used by institutions with cerliponase alfa experience may assist other institutions in process development. Continued sharing of experiences will be essential for developing standards and patient care guidelines.