Page 80 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

Usually patients are advised and taught, how to take care of their own skin, and we teach
them that that say they have ended up with moist desquamation, we teach them how to do
saline soaks and apply the Flamazine ◊and keep open to air. So we do all that for the
patient to be able to manage themselves. (P#3)

In this section, findings have been presented regarding Theme One: The context of wound

care practices in radiotherapy. Four sub-themes of Hierarchy in model of care, Communication,

Resource management and Education were discussed. While all of these aspects work together

for patient-centred care, these factors might influence variations in wound care practices based

on individual patient needs during radiotherapy.

Theme Two: Nurses’ perceived role in clinical decision-making. This theme highlighted

the various nursing roles in radiation oncology wound care. The semi-structured telephone

interviews revealed that RTNs participate in clinical research, apply relevant knowledge and use

innovative techniques, anecdotal evidence, practice experience, in-services, expert opinions,

community referrals and research-based decisions to guide their practice.

The sub-theme of Nursing autonomy in wound assessment and care is a key feature in the

RTN’s role. Trust in nursing competence is described by a participant, “When a prescription is

required for Flamazine◊, we do have to speak to with the physician to get it. They are quite

comfortable with our assessment skills to provide that” (P#3). Another participant referred to

the unique contribution of nursing assessment.

Primary care nursing that strengthened competence in clinical assessment and judgment

was apparent, as the participants explained, “We do try for the patients to see more or less the

same, one or two nurses. Everyone has the same set of eyes evaluating… the doctors are very

confident in the nursing expertise” (P#1).