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确定基于证据的由护士主导的放射性皮炎评估与管理方案的必要性。

Identification of need for an evidence-based nurse-led assessment and management protocol for radiation dermatitis.

作者信息

Oddie Kay, Pinto Margaret, Jollie Shelley, Blasiak Elizabeth, Ercolano Elizabeth, McCorkle Ruth

机构信息

Author Affiliations: Smilow Cancer Hospital at Yale-New Haven (Mss Oddie, Pinto, Jollie, and Blasiak and Dr McCorkle); Yale University School of Nursing (Drs Ercolano and McCorkle), New Haven, Connecticut.

出版信息

Cancer Nurs. 2014 Mar-Apr;37(2):E37-42. doi: 10.1097/NCC.0b013e3182879ceb.

Abstract

BACKGROUND

Radiation therapy is used globally as a standard treatment for many forms of cancer. Skin damage or radiation dermatitis is the most common effect of radiation therapy.

OBJECTIVES

The study aims were to survey nurses to identify methods used to screen, manage, and monitor acute skin reactions within the radiation departments of an urban, northeastern teaching hospital and its network facilities and identify strategies to establish a mechanism for ongoing communication among the nurses to develop and implement an evidence-based protocol.

METHODS

Using an online self-report survey format (SurveyMonkey), radiation nurses were asked to describe their current practice related to assessing and monitoring radiation dermatitis, areas of expertise, skin assessment tools used, frequency of skin assessment, and interventions used to manage patients with radiation dermatitis.

RESULTS

Twenty-two radiation nurses (100%) representing all 8 facilities within the network responded. Tools to assess patients' skin, the frequency of skin assessments, and products used to manage skin reactions varied among the nurses. Nurses also assessed patients for additional factors including nutritional status, presence of other diseases, and medications.

CONCLUSIONS

Our results validated the need for a system-wide approach to manage patients undergoing radiation therapy, specifically a skin care protocol that defines type and frequency of skin assessments as well as recommends treatments for prevention and management of common skin conditions.

IMPLICATIONS FOR PRACTICE

The establishment of a standard method of assessing the skin will improve quality of care provided in the radiation departments and potentially limit patient complications and costs.

摘要

背景

放射治疗在全球范围内被用作多种癌症的标准治疗方法。皮肤损伤或放射性皮炎是放射治疗最常见的副作用。

目的

本研究旨在调查护士,以确定在一所位于东北部城市的教学医院及其网络设施的放射科内用于筛查、管理和监测急性皮肤反应的方法,并确定建立一种机制,以便护士之间进行持续沟通,从而制定和实施循证方案。

方法

采用在线自我报告调查形式(SurveyMonkey),要求放射科护士描述其目前在评估和监测放射性皮炎方面的做法、专业领域、使用的皮肤评估工具、皮肤评估频率以及用于管理放射性皮炎患者的干预措施。

结果

代表网络内所有8个机构的22名放射科护士(100%)做出了回应。护士们在评估患者皮肤的工具、皮肤评估频率以及用于处理皮肤反应的产品方面存在差异。护士们还评估患者的其他因素,包括营养状况、是否存在其他疾病以及用药情况。

结论

我们的结果证实了需要采用全系统方法来管理接受放射治疗的患者,特别是制定一份皮肤护理方案,明确皮肤评估的类型和频率,并推荐预防和处理常见皮肤状况的治疗方法。

对实践的启示

建立一种评估皮肤的标准方法将提高放射科提供的护理质量,并有可能减少患者并发症和费用。

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