Effect of implementing a nursing protocol on adult trans-hepatic arterial chemoembolization patients' outcomes

Abstract

Abstract Background: Careful monitoring for patient with hepatocellular carcinoma who receiving trans-arterial chemoembolization in adult intensive care units to reduce complications remains mandatory for nurses. The study aimed to evaluate the effect of implementing a nursing protocol on patients' outcomes undergoing trans-hepatic arterial chemoembolization. Quasi experimental research design was used in this study. Subjects: All adult patients who diagnosis with hepatocellular carcinoma and receiving trans-arterial chemoembolization at the liver intensive care unit and gastroenterology department at Al-Rajhi liver hospital were involved in this study. Two tools were used. Tool one: patient assessment questionnaire and includes 4 parts, tool two: patient outcomes assessment questionnaire. Methods: The nursing protocol on trans-arterial chemoembolization was implemented by the researcher from the day before procedure until discharge, the researcher assess site of insertion, post embolization syndrome after procedure and recorded it. Results: Findings of the present study revealed significant improvement in pain scores as it was 3.77±0.59 in the control group 4 hours after TACE while it was 3.19±0.63 in the Study group , and Mean ± SD was 3.95±0.58 in the control group 6 hours after TACE in comparison to 3.15±0.75 in the study group. Insertion site and ICU stay values of less than p=0.005, p=0.5 and p=0.05 respectively in response to implementing nursing protocol. Conclusion: implementing the nursing protocol on trans-hepatic arterial chemoembolization appear to be effective in terms of reducing incidence and consequences of post procedure complications. Recommendation: Patients and their caregivers need to be apprised of post embolization syndrome symptoms prior to TACE and provided with adequate nursing care for symptom control.