Identification of need for an evidence-based nurse-led assessment and management protocol for radiation dermatitis

Radiation therapy is used globally as a standard treatment for many forms of cancer. Skin damage or radiation dermatitis is the most common effect of radiation therapy.

The study aims were to survey nurses to identify methods used to screen, manage, and monitor acute skin reactions within the radiation departments of an urban, northeastern teaching hospital and its network facilities and identify strategies to establish a mechanism for ongoing communication among the nurses to develop and implement an evidence-based protocol.

Using an online self-report survey format (SurveyMonkey), radiation nurses were asked to describe their current practice related to assessing and monitoring radiation dermatitis, areas of expertise, skin assessment tools used, frequency of skin assessment, and interventions used to manage patients with radiation dermatitis.

Twenty-two radiation nurses (100%) representing all 8 facilities within the network responded. Tools to assess patients' skin, the frequency of skin assessments, and products used to manage skin reactions varied among the nurses. Nurses also assessed patients for additional factors including nutritional status, presence of other diseases, and medications.

Our results validated the need for a system-wide approach to manage patients undergoing radiation therapy, specifically a skin care protocol that defines type and frequency of skin assessments as well as recommends treatments for prevention and management of common skin conditions.

The establishment of a standard method of assessing the skin will improve quality of care provided in the radiation departments and potentially limit patient complications and costs.