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中性粒细胞减少症:知识现状 第二部分

Neutropenia: state of the knowledge part II.

作者信息

Nirenberg Anita, Parry Bush Annette, Davis Arlene, Friese Christopher R, Wicklin Gillespie Theresa, Rice Robert David

机构信息

School of Nursing, Columbia University, New York, NY, USA.

出版信息

Oncol Nurs Forum. 2006 Nov 27;33(6):1202-8. doi: 10.1188/06.ONF.1202-1208.

Abstract

PURPOSE/OBJECTIVES: To summarize the current available evidence for oncology nurses so that they may predict and prevent complications of chemotherapy-induced neutropenia (CIN), provide optimal education to patients, and become familiar with the state of the knowledge of neutropenia by understanding the evidence and guidelines for patients with cancer who may experience CIN.

DATA SOURCES

Review of primary literature, meta-analyses, available systematic reviews, clinical practice guidelines, and discussions at the State of the Knowledge on Neutropenia Symposium.

DATA SYNTHESIS

The evidence for nursing interventions to prevent CIN complications is underdeveloped. Strong empirical support to prevent infection in patients with CIN (e.g., restrictions in diet, isolation procedures, providing accurate patient education) is lacking. Several areas of preventive measures by patients, hand washing, and skin care have a stronger evidence base and should have high priority on patient education plans.

CONCLUSIONS

Strong evidence is available for several nursing interventions to prevent infection in patients with CIN. Many existing practices lack empirical support and should be identified and reviewed in the clinical setting for appropriate patient management.

IMPLICATIONS FOR NURSING

Oncology nurses can use the findings from the symposium to revise their care standards for patients anticipated to experience CIN. Research and practice performance improvement projects may be undertaken by oncology nurses to improve the delivery of evidence-based nursing care to this vulnerable patient population.

摘要

目的/目标:为肿瘤护理人员总结当前可得的证据,以便他们能够预测和预防化疗引起的中性粒细胞减少症(CIN)的并发症,为患者提供最佳教育,并通过了解可能发生CIN的癌症患者的证据和指南,熟悉中性粒细胞减少症的知识状况。

数据来源

对原始文献、荟萃分析、现有系统评价、临床实践指南以及中性粒细胞减少症知识现状研讨会上的讨论进行综述。

数据综合

预防CIN并发症的护理干预证据尚不充分。缺乏预防CIN患者感染的有力实证支持(例如,饮食限制、隔离程序、提供准确的患者教育)。患者采取的一些预防措施领域,如洗手和皮肤护理,有更强的证据基础,应在患者教育计划中列为高度优先事项。

结论

有强有力的证据支持几种护理干预措施可预防CIN患者感染。许多现有做法缺乏实证支持,应在临床环境中予以识别和审查,以进行适当的患者管理。

对护理的启示

肿瘤护理人员可利用研讨会上的研究结果修订预期发生CIN患者的护理标准。肿瘤护理人员可开展研究和实践绩效改进项目,以改善对这一脆弱患者群体的循证护理服务。

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