Development and Evaluation of Clinical Practice Guidelines of Safety Chemotherapy Clinical Nursing Care

• Main Authors: Hsiu-Hua Lee, 李秀花
• Other Authors: Fan-Hao Chou
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/81655661259915600851

碩士 === 高雄醫學大學 === 護理學研究所 === 99 === Chemotherapy is the main treatment for patients with advanced-stage cancer. Nurses have to perform complex chemotherapy treatments everyday based on their professional knowledge and evidence-based skills. The purpose of this study was to develop evidence-based clinical nursing guidelines for safety chemotherapy treatments for nurses and evaluate their applicability. Research methods of this study included: (1) developing evidence-based clinical nursing guidelines for safety chemotherapy treatments by setting up a multidisciplinary working group at a medical center in Southern Taiwan, analyzing current situations and problems of chemotherapy treatments and clinical nursing practice, conducting systematic literature reviews of chemotherapy treatments, drafting and amending the recommendations for the evidence-based clinical nursing guidelines, using the Delphi consensus decision-making process to develop the evidence-based clinical nursing guidelines and reviewing the guidelines through Appraisal of Guidelines for Research and Evaluation (AGREE) instrument conducted by external and methodological experts. (2) Evaluating the effects of the clinical nursing guidelines for safety chemotherapy treatments from patients’ and nurses’ perspectives. Focus group interview was applied in this study to explore patients’ opinions on the clinical nursing guidelines. A questionnaire survey was also applied in this study to understand nurses’ perspectives on the clinical nursing guidelines including difficulties, feasibilities and obstacles of its implementation. The results of this study showed that: (1) the evidence-based clinical nursing guidelines for safety chemotherapy treatments included four subjects and 100 suggested items. Twenty-eight experts were invited to answer two rounds of questionnaires applying the Delphi consensus decision-making process. After the first round questionnaire using open-ended questions, the experts'' opinions of the revised clinical nursing guidelines were collected by structural questionnaire in a second round. About 75% of the experts answered “agree completely (4 points)” on the correctness of the guidelines in 98 items (95.14%). Four clinical experts and two methodological experts recommended implementing the guidelines in clinical nursing practice. (2) Fourteen patients of the focus group interview were in 100% agreement with the contents of the guidelines and considered that these should be practiced in clinical nursing settings. A total of 340 nurses completed the questionnaire. Most nurses considered the guidelines could be practiced in clinical nursing. About 34% of the nurses mentioned that some items of the guidelines were difficult to be implemented. The clinical nursing guidelines for safety chemotherapy treatments established in this study were evidence-based and with quality. These guidelines can be widely implemented by nurses in Taiwan. In addition, applicability of the clinical nursing guidelines for safety chemotherapy treatments should be considered in order to effectively implement these guidelines.