Article type
Abstract
Background: The most common complication after cancer patients receive chemotherapy and/or radiotherapy is bone marrow suppression. When treatment destroys bone marrow stem cells and inhibits hematopoietic function, it could induce neutropenia, anemia, or thrombocytopenia. These serious adverse events can have a significant impact on progress to sepsis, prolonged hospitalization, mortality, morbidity, and healthcare costs. Based on the TVGH EBM framework, a 5-phase clinical practice guideline development was updated.
Objective: The aim of this study was to update a clinical practice guideline for providing nursing care to cancer patients receiving myelosuppressive chemotherapy and/or radiotherapy in an acute care hospital in north Taiwan.
Methods: A 5-phase design was available to develop the clinical practice guideline: In Phase I, members of a multidisciplinary medical care team were invited to participate in the designing of the clinical guideline development working group. In Phase II, we conducted comprehensive systematic reviews. We searched articles from database such as Cochrane Library, PubMed, CINAHL, ProQuest, Joanna Briggs Institute, et al. In total, 38 studies were retrieved, including 31 systematic reviews and 7 clinical guidelines from 2012 to 2023. In Phase III, the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was used to appraise the systematic reviews, and the Appraisal of Guidelines for Research & Evaluation version II was used to appraise the clinical guidelines. In Phase IV, a focus group including 6 patients and 9 healthcare team members were invited to understand their experiences for cancer patient immunodeficiency care in hospital. In Phase V, a survey was designed to detect the feasibility of the clinical guideline, which was establish by the results from Phases III and IV. Thirty-five clinical medical members from a hospital setting were asked to write the questionnaire.
Results: A 129-item clinical guideline was updated including 9 domains: neutropenia assessment, anemia assessment, thrombocytopenia assessment, neutropenia management, anemia management, thrombocytopenia management, diet and nutritional managements, traditional Chinese medicine, and environmental protection strategies.
Conclusions: These results might help to revise the clinical management standards for immunodeficiency care, to implement through education and training, and to apply the quality care for cancer patients.
Objective: The aim of this study was to update a clinical practice guideline for providing nursing care to cancer patients receiving myelosuppressive chemotherapy and/or radiotherapy in an acute care hospital in north Taiwan.
Methods: A 5-phase design was available to develop the clinical practice guideline: In Phase I, members of a multidisciplinary medical care team were invited to participate in the designing of the clinical guideline development working group. In Phase II, we conducted comprehensive systematic reviews. We searched articles from database such as Cochrane Library, PubMed, CINAHL, ProQuest, Joanna Briggs Institute, et al. In total, 38 studies were retrieved, including 31 systematic reviews and 7 clinical guidelines from 2012 to 2023. In Phase III, the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was used to appraise the systematic reviews, and the Appraisal of Guidelines for Research & Evaluation version II was used to appraise the clinical guidelines. In Phase IV, a focus group including 6 patients and 9 healthcare team members were invited to understand their experiences for cancer patient immunodeficiency care in hospital. In Phase V, a survey was designed to detect the feasibility of the clinical guideline, which was establish by the results from Phases III and IV. Thirty-five clinical medical members from a hospital setting were asked to write the questionnaire.
Results: A 129-item clinical guideline was updated including 9 domains: neutropenia assessment, anemia assessment, thrombocytopenia assessment, neutropenia management, anemia management, thrombocytopenia management, diet and nutritional managements, traditional Chinese medicine, and environmental protection strategies.
Conclusions: These results might help to revise the clinical management standards for immunodeficiency care, to implement through education and training, and to apply the quality care for cancer patients.