Prevention and management of radiation dermatitis for patients with Nasopharyngeal carcinoma: a best practice implementation project

Background: Radiation dermatitis are one of the most common complications during radiation therapy, which affects 85% and 95% of patients. Severe radiation dermatitis can not only reduce the quality of life but also affect the continuity of treatment, significantly diminishing the effectiveness of radiotherapy. Although there were guidelines regarding the management of dermatitis, dermatitis among patients remain suboptimal. Aim: This best practice implementation project aimed to implement an evidence-based practice in preventing and managing patients with radiation dermatitis, thereby improving the compliance of clinical practice with the best evidence and reducing serious dermatitis in NPC Methods: This was an evidence-based audit and feedback project that used a three-phase approach at a tumor specialized hospital in China. Phase 1 included the development of seven evidence-based audit criteria and carrying out baseline audit on 22 patients using the JBI’s Practical Application of Clinical Evidence System in the Department of Radiation Oncology of Sun Yat-sen universiy cancer centre. Phase 2 utilized the Getting Research into Practice component of the Practical Application of Clinical Evidence System to identify barriers to compliance with best practice principles and developed strategies and resources to improve compliance. Phase 3 involved conducting a follow-up audit using the same audit criteria to assess the results of interventions implemented to improve practice and identify issues that would be addressed in future audit. Results: After implementing the evidence, the incidence rate of severe radiation dermatitis(≥Grade Ⅲ) decreased from 9.09%(2/22 cases) to 0% (0/22 cases). A comparison between the pre-implementation and post-implementation findings showed significant improvements for all audit criteria, and patients’ compliance with the radiation dermatitis management protocol increased to between 59.09% and 100%. Notably, the compliance rate increased from 0 to 100% for audit criterion 1,2,5,9,12,and 15. Conclusions: The implementation of this project improved patients’ compliance on dermatitis management among NPC patients and reduced the incidence rate of severe dermatitis.