Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Shum NF(1),Choi HK(1),Rockson Wei(1), Lau PY(1), Dominic Foo CC(1)
Affiliation :
(1) epartment of surgery, Queen Mary Hospital
Introduction :
Radiation proctitis (RP) was commonly seen in patients with pelvic cancers including the rectum, prostate or reproductive organs. About 5 to 20% of patient underwent RT reported radiation-induced rectal injury. Radiation proctitis can be classified into acute or chronic radiation proctitis. Numerous treatment options for RP existing but no best option found.
Objectives :
This study was aim to design an evidence based approach to review the effectiveness of a nurse led sucralfate enema educational program reduce rectal bleeding. PICO format was used for framing this study.
Methodology :
This was a prospective study in which the participants were referred by colorectal specialists to nurse clinic. Study participants received a nurse educational program on self-administration sucralfate enema. A clinical protocol was set up and patient leaflet was designed. Two educational program sessions were designed for patients and their caregivers included technique of administration of sucralfate enema. These included the drug preparation, proper handling of instillation utensils and correct method of administration of sucralfate enema. Patient have to perform twice daily self-administration of sucralfate enema, prepared using two 1 g package sucralfate gel mixed with 40ml of water to produce a paste-like consistency for 4 weeks. The main outcome measures were reduction of rectal bleeding and secondary outcomes included hospital admission and blood transfusion
Result & Outcome :
From April 2021 to April 2023, a total of 42 patients (22 men and 20 women) with a mean age of 71.6 years (standard deviation [S.D.] 11.06 years) participated the study. There was a statistically significant reduction of rectal bleeding with the mean score reduce from 2.55 (SD 062) to 0.47(SD.050) with p value <0000. The mean score of modified therapy oncology group rectal toxicity scale was also decreased from 2.43 to 0.57 with p value <0.000. Patients requiring argon beam coagulation reduced the utilization rate to 16.67% (7) patients from 35.71%. Patients requiring blood transfusion were reduced from 33.33 % (14) to 11.9%. Conclusion Sucralfate enema was effective to control radiation related rectal bleeding. This study help to reduce the burden of hospital admission and dependence of argon beam coagulation or blood transfusion requirement. Further study for the generalization was need to test on the efficacy and also the long term effectiveness.
