抗肿瘤药物相关皮疹预防与管理审查指标的制定及障碍因素分析OA

Objective:To evaluate the clinical application status of prevention and management of antineoplastic drug-related rashes in general surgery(including gastrointestinal surgery,hepatobiliary surgery,thyroid and breast surgery),thoracic surgery and oncology,analyze the obstacles and promoting factors,and formulate reform strategies.Methods:Based on the evidence-based health care model of Joanna Briggs Institute in Australia,a total of 22 pieces of evidence for prevention and management of antineoplastic drug-related rashes were summarized.Establish review indicators and clear review methods,conduct a baseline review of the system,medical staff,patients and their families from June 10,2024 to July 10,2024,analyze the obstacles and promoting factors according to the review results,and formulate corresponding reform strategies.Results:A total of 8 review indicators were established,of which 3 were 0 and 4 were below 30%.Only one review indicator has an implementation rate of 100%.The passing rate of nurses'examination of evidence-related knowledge was 48.15%.The main obstacles in evidence-based nursing practice include the lack of antineoplastic drug-related rashes prevention and management process,incomplete antineoplastic drug-related rashes evaluation tools,lack of relevant health education materials,and lack of relevant knowledge and skills of medical staff.The main promoting factors include strong organizational leadership,experience and culture of supporting change in each department,and the participation of key personnel who have been identified as needing support in discussion and project implementation.According to this,the corresponding reform strategies are formulated,including improving the prevention and management process of antineoplastic drug-related rashes,organizing training and special study,improving health education materials and putting them on the hospital wisdom education system,improving the writing template of nursing records and carrying out continuous quality monitoring.Conclusions:There is a big gap between clinical nursing evidence and practice.Obstacles and promoting factors in clinical situations should be scientifically and comprehensively evaluated,and targeted reform strategies should be adopted to promote the effective transformation of evidence into clinical practice and improve the quality of nursing.