Page 150 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

148
WOUND CARE

Your Involvement:
I am grateful for your involvement as an expert consultant in the consensus-building process.
Your feedback will enable development of collaborative guidelines for inter-professional best
practice. I have included five guiding questions for your input. Depending on your preference,
you can send me an e-mail with your responses, or we can set a time to discuss your responses
over the phone.

Guiding Questions;
1. Can you comment on the assumption that removing wound dressings prior to daily
radiation treatment is best practice?
2. How can the practice of removing or radiating through dressings be effectively
evaluated? What evidence is needed to develop a practice guideline?
3. The term “consistency” in wound care practices seems to be interpreted on individual
perspectives rather than standardized practices. How can consistency in wound
assessment and dressing management be facilitated?
4. Based on the preliminary findings, what recommendations would you suggest for further
research and practice?
5. How would you interpret the following spectrum of data in relation to inter-professional
practice (Excerpt #1), practice change (Excerpt #2), and clinical decision-making
(Excerpt #3)

EXCERPT #1: A respondent (P#4) equates inter-professional practice with holistic care.

R: How do nurses in your Cancer Care Center perceive their role in relation to inter-
professional relationships in the area of radiation oncology wound care?
P#4: There’s multiple facets that you have to address; we look at whole patient. We don’t
look at just one aspect of that patient, so even if I’m seeing a patient for wound care
management, I am looking at every other factor that is going into the care… So there’s
never just one issue happening with them…When it comes to wound care management
it’s the wound assessment, it’s looking at the patient’s overall health, looking at if they’re
having subsequent chemotherapy. What’s happening with their labs, their general health,
nutrition? It depends on type of wound, it is as well. Are we assessing what type of wound
so we have to know the cause, is it healable, non-healable, are we in maintenance mode
because of different underlying factors that are happening. Is it a non-healable palliative
type wound?… we really have to look at fully at the whole patient before we make any
decisions regarding the wound, and then with the wound; It’s a full thorough wound
assessment before we make any determination of what kind of dressings we will be using.