Developing and Implementing a Radiation Dermatitis Care Bundle in Head and Neck Cancer Patients

Background: Radiation dermatitis(RD) are relatively frequent skin side effect during treatment of head and neck cancer (HNC) with radiotherapy (RT). The effects of severe RD may require interruption in or cessation of treatment, and also impact on the quality of a patient's life causing by pain, discomfort and limit activities. Objective: This innovation project was to identify the evidence-based interventions for RD. Creating and implementing a bundle of care and measuring the effects on the incorrect rate of patient self-care and the incidence of severe RD. Methods: This project was carried out between May 2013 and December 2013 at medical center. The team comprised five advanced practice nurses and two doctors with expertise in the field of wound, oncology and radiology. Firstly, through a structured evidenced-based review process to create a care bundle, consisting of six elements of care. Secondly, the incidence of severe RD and the incorrect rate of patient self-care were compared before and after implementation of a care bundle. Results: A total of 23 HNC patients were treated with RT. The median age of the patients was 69 years, and 82 % were male. The incidence of severe RD decreased from 25% to 10%. The incorrect rate of patient self-care reduced significantly from an average of 63% to 16.7 % . Conclusion: This implementation of a RD care bundle was associated with decreased the incidence of sever radiation dermatitis in head and neck patients undergoing RT and its showed a positive impact on patient skin self-care.