Evidence-Based Nursing Achieves Better Postsurgical Outcomes in Liver Cancer

Evidence-based nursing (EBN) was associated with positive outcomes, compared with conventional care, in the postoperative period in patients who underwent surgery for hepatocellular carcinoma (HCC), according to the findings of a meta-analysis reported in the International Wound Journal.

This meta-analysis aimed to determine whether postoperative outcomes differed based on receipt of EBN or conventional perioperative care among patients who underwent surgery for HCC. 

The researchers described conventional care as nursing care that effectively promotes patients’ postoperative recovery. However, this care typically does not incorporate patients’ wishes nor does it include spiritual and psychological care. 

EBN was described as nursing care based on clinical information integrated with experience with nursing problems in clinical practice. It emphasizes the use of evidence and incorporates the values, wishes, and actual situation of patients. 

Data evaluated were from relevant randomized controlled trials identified through searches of multiple databases, including PubMed, Web of Science, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database, and China National Knowledge Infrastructure. 

Eligible randomized controlled trials included an experimental group that received perioperative EBN and a control group that received conventional care. Outcomes in the analysis involved wound infections and postoperative complications.

A total of 15 randomized, controlled trials met inclusion criteria, representing a total of 1374 patients with HCC. Studies had been published from 2016 through 2023. Across these studies, 687 patients received EBN care, and 687 patients received conventional care. 

The rate of wound infections was lower in the patients who received EBN care, compared with conventional care. Wound infections were reported in 16 (2.33%) patients in the EBN group and 49 (7.13%) patients in the conventional care group (odds ratio [OR], 0.32; 95% CI, 0.18-0.56; P <.001). 

Postoperative complications also were less common in patients who received EBN care than in those who received conventional care. Postoperative complications were reported in 56 (8.15%) patients in the EBN group and in 180 (26.20%) patients in the conventional care group, (OR, 0.22; 95% CI, 0.15-0.31; P <.001).

“Compared to conventional care, the implementation of EBN during the perioperative period of [hepatocellular carcinoma] can significantly reduce the incidence of wound infections and postoperative complications, and has high clinical application and promotion value,” the researchers wrote in their report. 

This analysis is limited by the number of studies and patients included, thereby limiting the reliability and generalizability of these results. Therefore, the researchers suggest further confirmation of the study’s results is needed, including studies with larger sample sizes.