Nirenberg Anita, Reame Nancy K, Cato Kenrick D, Larson Elaine L
Clinical Nursing in Hunter-Bellevue School of Nursing at Hunter College in New York, NY, USA.
Oncol Nurs Forum. 2010 Nov;37(6):765-73. doi: 10.1188/10.ONF.765-773.
PURPOSE/OBJECTIVES: To describe oncology nurses' use of National Comprehensive Cancer Network (NCCN) clinical practice guidelines for chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN).
Cross-sectional survey design; descriptive, correlational analysis.
E-mail invitation to Web-based survey.
Random sample of 309 Oncology Nursing Society (ONS) members with e-mail addresses who provide care to adult patients receiving chemotherapy.
The investigator-developed Neutropenia Oncology Nurses Survey was used. Descriptive tests compared respondents' personal and professional characteristics to those of general ONS members; nonparametric chi-square and Kruskal-Wallis tests were used to correlate respondents' survey subscale scores with demographic data. Significant associations were entered into multiple logistic regression models.
The Neutropenia Oncology Nurses Survey's subscales measured subjective norm, attitude, perceived competence and confidence, perceived barriers, and use of NCCN clinical practice guidelines for CIN and FN.
Response rate of nurses who opened the survey was 50%. Most practiced in community versus academic centers. Eighty percent reported using the NCCN clinical practice guidelines for CIN and FN. Respondents were more likely to use clinical practice guidelines when they were expected to by physician and nurse colleagues, they perceived fewer barriers, or they held advanced oncology certification.
This study was the first to assess oncology nurses' reported use of NCCN clinical practice guidelines for CIN and FN. It also demonstrated the feasibility of partnering with ONS for Web-based survey research.
The findings give insight into work-place barriers to evidence-based practice in various settings. Expanding dissemination and implementation of clinical practice guideline recommendations will support the development of oncology nursing standards for risk assessment, management, and patient and family education in CIN and FN.
目的/目标：描述肿瘤专科护士对美国国立综合癌症网络（NCCN）化疗引起的中性粒细胞减少（CIN）和发热性中性粒细胞减少（FN）临床实践指南的使用情况。
横断面调查设计；描述性、相关性分析。
通过电子邮件邀请参与基于网络的调查。
随机抽取309名拥有电子邮件地址的肿瘤护理学会（ONS）成员，这些成员为接受化疗的成年患者提供护理。
使用研究者自行编制的《中性粒细胞减少症肿瘤专科护士调查问卷》。描述性测试将受访者的个人和专业特征与ONS普通成员的特征进行比较；非参数卡方检验和克鲁斯卡尔-沃利斯检验用于将受访者的调查子量表得分与人口统计学数据相关联。显著关联被纳入多元逻辑回归模型。
《中性粒细胞减少症肿瘤专科护士调查问卷》的子量表测量主观规范、态度、感知能力和信心、感知障碍以及对NCCN CIN和FN临床实践指南的使用情况。
打开调查问卷的护士回复率为50%。大多数人在社区而非学术中心工作。80%的人报告使用NCCN CIN和FN临床实践指南。当医生和护士同事期望他们使用时、他们感知到的障碍较少或者他们拥有高级肿瘤学认证时，受访者更有可能使用临床实践指南。
本研究首次评估了肿瘤专科护士报告的对NCCN CIN和FN临床实践指南的使用情况。它还证明了与ONS合作进行基于网络的调查研究的可行性。
研究结果深入了解了不同环境下循证实践的工作场所障碍。扩大临床实践指南建议的传播和实施将支持制定CIN和FN风险评估、管理以及患者和家庭教育的肿瘤护理标准。
