放疗皮肤反应的评估及护理的最佳证据应用

Evaluation of radiotherapy skin reactions and application of best evidence in nursing care

目的:将放疗皮肤反应最佳证据应用于临床实践并评价其效果。方法:遵循Joanna Briggs Institute(JBI)临床证据实践应用模式,制定临床审查指标,基线审查以及应用障碍因素分析,实践变革和证据应用后再审查。比较证据应用前后病人护士知识水平变化以及放疗皮肤反应发生率和审查指标执行情况。结果:证据应用前后审查指标执行率有不同程度提升,最高提升100.00%,最低提升28.77%。护士和病人放疗皮肤相关知识水平得到提升,放疗皮肤反应发生率降低了20.43%,严重程度有不同程度降级。结论:放疗皮肤反应评估与护理最佳实践能够规范临床护士行为,改善科室相关管理制度和流程,提高了护士、病人对于放疗皮肤反应关注度及知识水平,在一定程度弥合了临床与证据之间差距,对于护士循证知识态度提升和护理质量改进有一定的影响。

Objective:To apply the best evidence of radiotherapy skin reactions to the clinical practice and evaluate the effect.Methods:Following the clinical evidence practice application model of the JBI Evidence-Based Care Center,it included baseline review before evidence application,practice changes,and re-examination of the effect of post-evidence application.Set the patient and nurse knowledge level,implementation rate of the evidence,the incidence of radiotherapy skin reactions before and after the best evidence application as the evaluation indicators.Results:The implementation rate of the evidence was increased from 28.77%to 100.00%.The knowledge level of nurses and patients related to radiotherapy skin has been improved;the incidence of radiotherapy skin reaction was reduced by 20.43%;the severity did also be decreased to varying degree.Conclusion:The best evidence practice of the evaluation and care of radiotherapy skin reactions could standardize the behavior of clinical nurses,improve the management procedure of the department,and prompt the nurses pay more attention to the reaction,increase the knowledge level of nurses and patients on radiotherapy skin reaction.This best evidence practice could bridge the evidence and clinical gap to a certain extent,indicating that there was a certain impact on the improvement of nurses′evidence-based knowledge and attitude and the nursing quality.