Development of Nursing Guidelines for Reducing the Occurrence of Hypersensitivity Reactionfrom Paclitaxel drug exposure Carboplatin in Gynecological Cancer Patient Sukhothai hospital.

Abstract

     This research and development aimed to design and develop nursing practice guidelines to reduce the incidence of hypersensitivity and reduce the severity of hypersensitivity to drugs in gynecologic cancer patients receiving Paclitaxel Carboplatin according to the evidence-based nursing model of Soukup (2000). The sample group consisted of 89 gynecologic cancer patients diagnosed by doctors to receive Paclitaxel Carboplatin chemotherapy for gynecologic cancer treatment at Sukhothai Hospital. Data were collected from the Paclitaxel Carboplatin hypersensitivity symptom record form, the level of hypersensitivity, and the duration of chemotherapy. Data were analyzed using descriptive statistics, including frequency, percentage, mean, standard deviation, and independent T-test and Chi-square test according to the characteristics of the data.
     The research results found that in Stage 1, 41.83 percent of patients experienced hypersensitivity and the severity ranged from level 1 to 4. 53.06 percent had a drug administration time exceeding 180 minutes, which was classified as Specific Clinical risk level E and H.  Phase 2: Search for empirical evidence related to the clinical problem. A total of 15 relevant literatures were obtained. Phase 3: Create nursing practice guidelines, test them and revise them twice. Evaluate the quality of the guidelines using the AGREE II assessment form from 5 relevant experts. The guidelines are called nursing practice guidelines for the administration of Paclitaxel Carboplatin in the SBT method. (Sukhothai hospital Best Titrate)  Phase 4: Implementation of SBT nursing practice guidelines for drug administration found that 1) the incidence of hypersensitivity in the experimental and control groups was different (p- value 0.05). 2) The severity of hypersensitivity in the experimental group did not exceed level 2, while in the control group it did not exceed level 4. 3) The proportion of drug receipt completed within 180 minutes of the experimental group was significantly different from the control group (p- value 0.05).