表皮生长因子受体抑制剂所致皮肤毒性症状管理的最佳证据应用

摘要

Objective:To implementing best evidence-informed practice of skin toxicity caused by EGFRIs,to improve the nurses' compliance of skin toxicity symptom management,to decrease the incidence and severity of patients' skin toxicity,and to improve the patients' quality of life.Methods:We adopted the standard procedure of Practical Application of Clinical Evidence System (PACES) of JBI evidence-based nursing center,and obtained the best related practice evidence in the Clinical Online Network of Evidence for Care and Therapeutics (COnNECT+) database of JBI,and formulated corresponding review criteria.The data were collected by field observation,interviews,and medical records.Results:About 5 criterion in the second audit achieved 100.00％ compliance.The patients' score of Skindex-16 was reduced from 25.18±17.29 to 7.59±6.79 (P=0.001).Conclusion:Audit of current practice and the implementation of strategies to improve compliance with evidence-informed practice were effective and appeared to reduce the incidence and severity of common EGFRIs-induced skin toxicities.%目的:将表皮生长因子受体抑制剂(EGFRIs)所致皮肤毒性的最佳证据应用于临床实践,提高护士在皮肤毒性症状管理中证据应用的依从性,降低患者皮肤毒性症状的发生率和严重程度,提高患者生活质量.方法:采用JBI循证护理中心的临床证据实践应用系统(PACES)的标准程序,获取JBI在线临床治疗及护理证据网络(COnNECT+)数据库中现有的相关最佳实践证据,制定相应审查标准.采用现场观察法、访谈、查阅护理病历收集数据.结果:第2轮审查中5条审查指标已达到100.00％,患者生活质量调查表得分从(25.18±17.29)分降低至(7.59±6.79)分(P=0.001).结论:EGFRIs所致的皮肤毒性症状管理的最佳证据应用能够规范护士的临床护理实践,提高患者生活质量.