Evidence-based intervention protocol of using ice water mouthwash in the prevention of stomatitis for patients undergoing autologous haematological stem cell transplantation

Abstract

Haematological stem cell transplantation (HSCT) is a revolutionary treatment for haematological malignancies. Although HSCT is potentially curative, patients usually develop stomatitis which is a common and debilitating complication after the transplantation. Furthermore, stomatitis may predispose patients to various complications which are associated with significantly increased morbidity and mortality.

In some studies, ice water mouthwash has been shown to be an effective method for the prevention of stomatitis. However, a high-level evidence-based protocol on the prevention of stomatitis has not been fully developed and it is not commonly practiced in most HSCT centers at present. A well established protocol can help to minimize the patients’ suffering and avoid prolonged hospitalization. The nurses who are involved in patient education, assessment, care for, and coping with stomatitis, play an important role to bring these innovations into practice.

In this regard, this translational research aims at developing an evidence-based protocol on using ice water mouthwash in the prevention of stomatitis for patients undergoing autologous HSCT. A systematic search for relevant literatures was performed with the use of five electronic databases. Six relevant studies were found. Critical appraisal on the relevant studies was conducted. The level of evidence extracted from the studies was graded according to the Scottish Intercollegiate Guidelines Network (SIGN) and were synthesized to establish the protocol for patients in the proposed setting. The implementation potential of the protocol was assessed in terms of the transferability, feasibility, and cost benefit ratio. An implementation and evaluation plan was established for comprehensive evidence-based protocol development.

The successful implementation of the protocol will be beneficial for the patients undergoing HSCT as it may hasten their recovery, shorten their hospital stay, and minimize their distressing experience and suffering.