Management of skin reactions during radiotherapy in Flanders (Belgium): a study of nursing practice before and after the introduction of a skin care protocol.
OBJECTIVE
To evaluate nursing practice in Flanders (Belgium) regarding skin care during radiotherapy and the effect of the introduction of an evidence based protocol on daily nursing practice.


METHODS
Nurses working at radiotherapy departments in Flanders were invited to complete a 58-item questionnaire. The survey was undertaken in 2001 (n=67) and end of 2006 (n=89). Following the survey in 2001 an evidence based skin care protocol was made available for radiotherapy nurses and presented at their respective radiotherapy services. The questionnaire asked to what extend they advised their patients about skin care topics grouped in four sections: prevention, erythema, dry desquamation, moist desquamation.


RESULTS
The surveys revealed large varieties in the management of skin reactions although there seems to be less variety and more consensus in the 2006 survey. Regarding preventive advice and the advice in case of erythema, dry desquamation and/or moist desquamation a major improvement was observed in the adoption of key principles such as washing and hydrating the irradiated site and the use of occlusive dressings and the omission of outdated techniques such as talcum powder, Eosin 2% and Gentian violet.


CONCLUSIONS
The management of skin reactions does not always correspond with current scientific knowledge. However, the results of this study show that the dissemination and implementation of a skin care protocol enhanced standardization in Flanders, improved adheration to evidence based guidelines and lead to the disappearance of outdated ritualistic practices.
D'haese
Sven
S
Department of Radiotherapy, Oncology Center, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium. sven.dhaese@uzbrussel.be
Van Roy
Marleen
M
Bate
Trees
T
Bijdekerke
Paul
P
Vinh-Hung
Vincent
V
D000328:Adult; D001530:Belgium; D016009:Chi-Square Distribution; D002985:Clinical Protocols / Q000592:standards; D055317:Evidence-Based Practice / Q000458:organization & administration; D005260:Female; D019983:Guideline Adherence / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009859:Oncology Nursing / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D011855:Radiodermatitis / Q000209:etiology / Q000451:nursing* / Q000517:prevention & control; D011878:Radiotherapy / Q000009:adverse effects; D012648:Self Care; D017592:Skin Care / Q000379:methods / Q000451:nursing / Q000592:standards; D011795:Surveys and Questionnaires