Evidence-Based Nursing Management of Semi-Implantable Intrathecal Drug Delivery Systems for Refractory Cancer Pain: Protocol Development and Clinical Evaluation.

This study developed an evidence-based nursing protocol for semi-implantable IDDS and evaluated its effectiveness in managing refractory cancer pain to standardize practice. Using the Joanna Briggs Institute (JBI) evidence translation model, 34 best-evidence statements were synthesized from literature (2015-2025) to construct a perioperative nursing protocol. This protocol was implemented in 32 patients (post-implementation group) and compared to 31 pre-implementation patients. Clinical outcomes, including analgesic effectiveness and adverse events, were evaluated, demonstrating the protocol's impact on improving patient care. The evidence-based protocol significantly improved pain relief rates and patient satisfaction (p < 0.05). Overall adverse events, including infections, were reduced (p < 0.05). Compliance with all 12 nursing quality indicators improved, especially home care education (p < 0.001). Nursing staff also demonstrated significant gains in IDDS knowledge, attitudes, practices, and dressing-change performance (p < 0.001). An evidence-based nursing protocol for semi-implantable IDDS in refractory cancer pain improved pain control, implementation of this evidence-based nursing protocol was associated with better pain control, fewer device-related adverse events and higher patient satisfaction, which supports its feasibility for wider clinical practice.