Abstract
OBJECTIVE: To integrate the best available evidence with the clinical practice for nursing care of radiation-induced oral mucositis (RIOM) in patients with head and neck cancer, develop an evidence-based practice protocol, and evaluate its effectiveness in clinical application. METHODS: Guided by the Knowledge-to-Action (KTA) framework, this study summarized the best available evidence for nursing care of RIOM in patients with head and neck cancer and adapted it to the clinical scenario based on expert opinions. An evidence-based practice protocol was developed by integrating the results of a baseline review and an analysis of barriers to implementation. The protocol was implemented in clinical settings, and its effectiveness was evaluated by assessing changes in outcomes before and after implementation, including nurses' implementation rate of review indicators, the incidence of severe RIOM, oral pain scores, and the onset time of different RIOM grades. RESULTS: After the clinical application of the evidence-based practice, the implementation rate of the 9 review indicators of nurses was significantly improved (P < 0.05). The incidence of severe RIOM at the end of radiotherapy decreased from 43.64% to 24.07%. The oral pain score was significantly reduced from 5.53 ± 1.62 to 4.44 ± 1.54 (P < 0.05). Additionally, the onset of grade I RIOM was significantly delayed during radiotherapy (P < 0.05), while no significant changes were observed in the onset time of grade II and III RIOM (P > 0.05). CONCLUSIONS: The implementation of an evidence-based practice protocol for the nursing care of RIOM in patients with head and neck cancer could enhance nurses' clinical performance, reduce the incidence of severe RIOM at the end of radiotherapy, alleviate oral pain, and delay the onset of mucositis. It could bridge the gap between evidence and clinical practice and enhance the quality of nursing care.