Page 87 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

the evolving role of the RTN. Perhaps, these inter-professional relationships will continue to

make radiation oncology a sustainable workplace for specialized nursing practice and improved

patient outcomes.

Summary of Integrated Findings

In this section, an integration of findings from phases II and III is presented. Analysis of

current practice as reported in the national environmental scan survey showed that there is

inconsistency in practice, particularly in relation to radiating through dressings. None of the

participants responded to the survey request to share standardized reference documents, such as

a Clinical Practice Guidelines in relation to radiating through wound dressings. The absence of

such standardized documents might explain some of the variations in whether or not to radiate

through dressings. While there was inconsistency in regard to radiating through dressings, the

survey results also revealed that there is generally consistency in the topical treatments used for

radiation induced skin reactions and malignant wounds during radiotherapy across Radiation

Oncology Centres in Canada.

The thematic analysis of the semi-structured telephone interviews describes the context

of nursing practice environment in wound care management as one that utilizes the integration

of clinical decision-making and inter-professional relationships to guide collaborative, patient-

centered practice. The complexity of the nursing role in radiation oncology wound management

is exhibited by these overarching themes of Integration and Patient-centred care. It is

noteworthy that a few centres have resources such as a radiation oncology nurse consultant, a

clinical resource nurse and experts in wound and ostomy care. While one of the participants

shared that their centre is looking at changing practices in regards to removal of dressings prior

to daily radiotherapy, it appears to be a local practice change that is in process. When complete