| Learning Objective #1: Discuss measurement of outcomes related to implementation of evidence-based oral care clinical practice guidelines (CPGs) in oncology | |||
| Learning Objective #2: Describe a structured evaluation plan that measures specific nursing and patient outcomes related to the implementation of evidence-based oral care CPGs in oncology |
Introduction: Use of evidence-based oral care CPG's is expected to positively impact outcomes across diverse oncology patient settings in an integrated health system. Present state of the science reflects that few structured algorithms for evaluating evidence-based practice have been developed and tested clinically.
Background: Prior to broader translation across the entire health system, an evaluation model was specifically designed to test this evidence-based oral care practice change in high-risk subgroups of oncology patients. The UPHS Evidence Based Utilization Framework guided the evaluation plan. Methods: A quasi-experimental pre-test/post-test design is being used to measure statistically and clinically significant changes in nurse- and patient-specific outcomes. To increase the effect size, the evaluation is being conducted in two matched pretest/posttest sub-groups (total n = 40) at high risk for oral complications: leukemics receiving inpatient chemotherapy and outpatients undergoing head/neck radiotherapy. Sixty oncology nurses practicing in these settings complete the sample.
Measures: All measures are performed at baseline and one month post-implementation. Nursing Outcomes: 1) Nursing knowledge is measured by an investigator-developed and piloted 12-item instrument; 2) Nursing documentation is assessed with a standardized checklist. Patient Outcomes: All measures are recorded 3 times weekly for 3 weeks per subject. 1) Adherence to the oral care regimen is measured by patient self-report; 2) Oral pain is measured by the Brief Pain Inventory; 3) Overall oral health is measured by five oncology advanced practice nurses (APN's) using the Oral Assessment Guide (OAG). Inter-rater reliability of these five APN's was sufficiently established during pilot testing, with Pearson R correlation coefficients ranging from 0.845 to 0.983.
Findings/Implications: Data collection and analysis will be completed during the next three months. This evidence-based CPG is expected to be refined and applied throughout this diverse health system with potential for adaptation across a diverse array of national and international oncology populations.
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Sigma Theta Tau International
9 July 2003