Effect of a Critical Practice Guideline on the Management of Nausea and Vomiting in Patients Undergoing Chemotherapy : A Best Practice Implementation Project in the Thai Context
Keywords:
Practice Guideline, Nausea and Vomiting Management, Cancer Treatment, ChemotherapyAbstract
This experimental study aimed to evaluate the effectiveness of a practice guideline for managing chemotherapy-induced nausea and vomiting (CINV) in cancer patients within the Thai healthcare context. The study was conducted at Tha-Bo Crown Prince Hospital, Nong Khai Province, involving 120 cancer patients receiving chemotherapy. The patients were recruited by convenience sampling between January and July 2024. The guideline was adapted based on an evidence-based healthcare framework, utilizing the seven-step evidence-based practice process from the Joanna Briggs Institute, Australia. Research instruments included: (1) a risk assessment tool for chemotherapy-induced nausea and vomiting, (2) Nausea and vomiting recording form, (3) Function Living Index : Emesis, and (4) Audit criteria checklist. Data were analyzed using descriptive statistics, frequencies, percentages, and Pearson’s chi-square test.
The results showed a significant improvement in symptom management. The proportion of patients experiencing no nausea or mild nausea increased from 40% to 95% (p-value < .001). Additionally, the proportion of patients with no vomiting or only mild vomiting that did not require medication increased from 65% to 100% (p-value < .001). Quality of life assessments indicated that participants maintained a good quality of life, with no significant negative impact from CINV before or after guideline implementation. Moreover, adherence to practice criteria showed a 100% improvement in audit criteria 1 and 4.
In conclusion, the practice guideline demonstrated effectiveness in managing CINV and can be applied in healthcare settings to improve patient outcomes.
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