Enhancing the Use of 5-Aminolevulinic Acid in Fluorescence-guided Surgery for High-grade Glioma: An Expert Nurse Practitioner Opinion-based Approach.

IF 1.6 4区 医学 Q2 NURSING
Lisa Scarpace, Nicole Archer, Michelle Belusic, Isabella Buonanno, Nini Eng, Alina Estevez, Jaclyn Garcia, Alexandra Schaber
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Abstract

Purpose: This report details the recommendations of a Nursing Best Practice Working Group, which aims to advance best practice in the use of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in patients with high-grade glioma (HGG).

Design: Quality Improvement Project.

Methods: These recommendations were gathered during a meeting of a Nursing Best Practice Working Group comprising expert nurses and practice administrators from five US centers of excellence in the management of HGG. Ahead of the meeting, a survey was taken to evaluate the views of each expert and surgical teams, patients and institutions on current benefits, challenges and practices associated with the use of 5-ALA FGS in HGG. The Nursing Best Practice Working Group then met to share their experiences, explore where consensus exists, and identify opportunities for enhanced patient management.

Findings: The advisors made recommendations to support improvements across a range of areas associated with multidisciplinary team delivery of 5-ALA FGS. These included specific issues surrounding the administration of 5-ALA, photosensitivity and low-light precautions, and key aspects relating to protocol development, content features, format and accessibility, and updates and education of both the multidisciplinary team and patients. Guidance was also gathered on a flowchart to support the practical delivery of patient care and detail roles, responsibilities, and timings.

Conclusions: This guidance provides direction for the development of practical, evidence-based protocols and educational approaches for multidisciplinary teams and patients. Such approaches can improve best practice in 5-ALA FGS in all institutes, irrespective of size, and when developed collaboratively provide the means to share best practice across institutes and reach consensus on patient care.

加强5-氨基乙酰丙酸在高级别胶质瘤荧光引导手术中的应用:一种基于专家护士执业医师意见的方法。
目的:本报告详细介绍了护理最佳实践工作组的建议,该工作组旨在推进在高级别胶质瘤(HGG)患者中使用5-氨基乙酰丙酸(5-ALA)荧光引导手术(FGS)的最佳实践:设计:质量改进项目:这些建议是在护理最佳实践工作组的一次会议上收集的,该工作组由来自美国五个 HGG 治疗卓越中心的专家护士和实践管理者组成。会前进行了一项调查,以评估每位专家、手术团队、患者和医疗机构对目前在 HGG 中使用 5-ALA FGS 的好处、挑战和相关做法的看法。随后,护理最佳实践工作组召开会议,分享他们的经验,探讨存在共识的地方,并确定加强患者管理的机会:顾问们提出了建议,以支持与多学科团队提供 5-ALA FGS 相关的一系列领域的改进。这些建议包括与 5-ALA 给药、光敏性和弱光下注意事项有关的具体问题,以及与方案制定、内容特征、格式和可及性、多学科团队和患者的更新和教育有关的关键方面。此外,还收集了有关流程图的指导意见,以支持患者护理的实际实施,并详细说明了角色、责任和时间安排:本指南为多学科团队和患者制定实用的循证协议和教育方法提供了指导。这些方法可以改善所有研究机构(无论规模大小)在 5-ALA FGS 方面的最佳实践,如果能合作开发,还能提供跨机构共享最佳实践的途径,并就患者护理达成共识。
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来源期刊
CiteScore
2.20
自引率
17.60%
发文量
279
审稿时长
90 days
期刊介绍: The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.
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