Research and practice on improving the skin toxicity management model of tumor targeted drugs based on evidence-based practice method
10.3760/cma.j.cn114015-20230911-00667
- VernacularTitle:基于循证实践方法改进肿瘤靶向药物皮肤毒性管理模式的研究与实践
- Author:
Liyuan FAN
1
;
Mengge LI
1
;
Yifu HE
1
;
Yufei XING
1
;
Ying YANG
1
;
Conglan DING
1
Author Information
1. 中国科学技术大学附属第一医院/安徽省肿瘤医院肿瘤内科一病区，合肥 230031
- Publication Type:Journal Article
- Keywords:
Evidence-based healthcare;
Evidence-based practice;
Antineoplastic agents;
Molecular targeted therapy;
Skin toxicity
- From:
Adverse Drug Reactions Journal
2024;26(4):217-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve the skin toxicity management model of tumor targeted drugs based on evidence-based practice method and apply it to clinical practice.Methods:Using the evidence-based practice method of Joanna Briggs Institute, evidence of skin toxicity management of tumor targeted drugs was formed by searching relevant guidelines and evidence-based medical literature at home and abroad, and conducting interviews and surveys with nurses and patients. Based on the evidence and in consultation with evidence-based medicine, nursing and clinical experts, the evidence was transformed into management improvement plans, and the skin toxicity checklist and care checklist were developed. The improvement scheme was applied to clinical practice, the training of nurses was strengthened, the nursing process was standardized and improved, and various forms of health education were provided to patients. Patients with skin toxicity who received targeted drug therapy in the Department of Oncology of Anhui Cancer Hospital from May to August 2023 were collected. Implementation of various management indicators by nurses before and after management improvement were compared. The occurrence and severity of skin toxicity in patients were compared to verify the effect of the improvement.Results:A total of 35 tumor patients with skin toxicity to targeted drugs were entered, including 26 males and 9 females, with age (60±10) years. Compared with before, the implementation rate of the 5 indicators after the management improvement, including the evaluation of skin toxicity and risk factors by nurses using the common terminology criteria for adverse events version 5.0, the qualified status of related nursing documents, the health education of skin care, and regular follow-up of patients, were significantly increased (from 0-31.4% up to 80%-100%), the differences were statistically significant (all P<0.05). After improvement, the incidence and severity of skin rash, skin dryness, skin reaction of hands and feet, and paronychia were significantly reduced, the score of skin care knowledge questionnaire was significantly increased [6.00(5.00, 8.00) vs. 8.00(7.00, 9.00), P=0.002], and the dermatology life quality index was significantly decreased [8.00(6.00, 9.00) vs. 6.00(5.00, 8.00), P=0.033]. The differences in anxiety and depression scores were not statistically significant (both P>0.05). Conclusion:The skin toxicity management of targeted drugs based on JBI evidence-based practice method can standardize the clinical nursing practice of nurses, improve the severity of skin toxicity in tumor patients, and improve their quality of life.
