The standardization of radiation skin care in British Columbia: a collaborative approach.

P atients undergoing radiation therapy receive information related to skin reactions and recommended management from radiation oncologists, RNs, and radiation therapists. Historically, at the British Columbia Cancer Agency (BCCA), the advice was experientially based and severely restricted patients’ use of personal hygiene products and topical preparations. Healthcare professionals used a variety of approaches to manage reactions. In addition, debates ensued about the benefi ts of cornstarch for erythema and dry desquamation and the use of gentian violet for moist desquamation. Suggestions regarding the use of soaps and lotions or wearing jewelry and undergarments varied and depended on the personal beliefs and experiences of staff rather than scientifi c evidence. As a result, patients often received inconsistent and, at times, confl icting advice. The scarcity of available research (Wickline, 2004) demonstrating that particular products or care plans could prevent, delay, or improve radiation skin reactions only encouraged the status quo. Recognition of the inconsistencies of practice among individuals, disciplines, and the four cancer centers of BCCA created an opportunity for improvement. In 1999, the BCCA professional practice leaders of nursing and radiation therapy proposed that interdisciplinary provincial guidelines be developed to standardize the care of radiation skin reactions across the province. This article reports the process that was undertaken to (a) develop evidence-based practice guidelines, (b) obtain consensus from healthcare disciplines involved in patient care, and (c) implement the guidelines throughout four geographically distinct BCCA centers. The guideline development process followed by the BCCA (see Figure 1) The Standardization of Radiation Skin Care in British Columbia: A Collaborative Approach