Much of the nursing care of patients experiencing side
effects from radiation therapy is based on tradition and provider
preference rather than actual evidence. The increased
complexity of patient care and demands from regulatory
agencies require nursing practice to be based on the best
available evidence. Multiple definitions of evidence-based
practice exist. Boswell and Cannon’s definition of evidencebased
practice as “a process of using confirmed evidence
(research and quality improvement), decision-making, and
nursing expertise to guide the delivery of holistic patient
care”4 directed this review, which discusses the evidence
where available, using the Oncology Nursing Society (ONS)
Putting Evidence into Practice (PEP) framework. The ONS
PEP resource identifies six levels of recommendations for
patient care and teaching on a variety of topics (http://www.
ons.org/Research/PEP). These categories are:
• Recommended for practice: interventions for which
effectiveness has been demonstrated by strong evidence
from rigorously designed studies, meta-analysis, or systematic
reviews, and for which expectation of harm is
small compared with the benefits.
• Likely to be effective: interventions for which effectiveness
has been demonstrated from a single rigorously conducted
controlled trial, consistent supportive evidence
from
well designed controlled trials using small samples, or
guidelines
developed from evidence and supported by
expert opinion.
• Benefits balanced with harm: interventions for which
clinicians and patients should weigh the beneficial and
harmful effects according to individual circumstances
and priorities.