Page 147 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

aptitude for the treatment of ulcerating tumors have been proven, can be used
regardless of their dosimetric characteristics.

 In all cases, the thickness of the dressing must be taken into account when
calculating the actual applied dose of radiation (Hollinworth & Mann, 2010;
Thilmann et.al., 1996).

Thus, although the available literature speaks to dressing type and procedure, few studies have
addressed removal of dressings for radiation therapy, the area of focus I address in the thesis.

Phase II: Environmental Scan

The research questions giving specific direction to the second phase of the project were,
(i) what is the current practice in Cancer Agencies with regard to wound dressing during
radiotherapy across Canada? and (ii) how do nurses perceive their role in clinical decision-
making and inter- professional relationships in this matter? The survey instrument developed for
the environmental scan was piloted at the Fraser Valley Cancer Center to test the process and
ensure validity of the contents, prior to the actual administration of the national environmental
scan survey. After approval from both Trinity Western University and British Columbia Cancer
Agency Research Ethics Board, one nurse per radiation oncology center was contacted for a
national environmental scan of 34 radiation oncology centres in Canada. 18 nurses responded to
the online survey invitation (n=18). Semi-structured telephone interviews were conducted with
four nurse participants (n=4) to understand the context of nursing practice environment in
radiation oncology in more depth; particularly in the area of wound management, clinical
decision-making and inter-professional practice. Data analysis was done using descriptive
statistics for the survey data and thematic analysis for the semi-structured interviews.

Sample: Data regarding the current practice in wound care was collected from 18 centres
from the provinces of Alberta, British Columbia, New Brunswick, Ontario, Saskatchewan and
Quebec. The respondents to this Pan-Canadian survey included staff nurse (39%), nurse educator
(33%), nurse leader (22%) and an oncology resource nurse. Though only 16 of the 18 survey
responses received were complete, all available data was used in the analysis.

Results of Survey:
 The survey results show that wound dressings are always removed prior to
radiation treatments at 50% of the centres, while they are sometimes left in place
at 50% of the centres. Based on these results, it is concluded that there is
inconsistency in practice regarding radiating through wound dressings across
Canada.

 Though the descriptive statistics show that it is unclear as to whose decision it is
to remove or radiate through dressings, it is noted that the registered nurse is not
the sole decision maker in this aspect of patient care.