Evaluating Metronidazole Therapy for Malignant Wound Management

This report explores the use of metronidazole in the treatment of malignant wounds, focusing on its effectiveness in reducing malodor and improving patient outcomes. The report utilizes the ACE Star Model of Knowledge Transformation to present an evidence-based approach to nursing care. It discusses the problem of malignant wounds, common in end-stage cancer patients, and the limitations of traditional treatments. The report reviews supporting evidence from various studies, highlighting the benefits of metronidazole in malodor reduction. An action plan is outlined, detailing desired outcomes, measurement methods, and the roles of key stakeholders, including nurses, medical officers, and patients. The report also addresses the importance of ethical considerations, patient education, and mental health support. References from various research papers and studies are provided to support the findings and recommendations.

Use of Metronidazole to treat
bacteria and reduce malodorous in
malignant wounds
Presented by

ACE Star Model of Knowledge Transformation
5-star model that is used
for evidenced based
practice in nursing care
Effective comparison of old
and new concepts
Generation of cause and
effect relationship
It helps in proper
procurement of the
evidence based practice
(Stevens, 2013)
(Source: Stevens, 2013)

Problem to be discussed
Effective Management of
Malignant Wound

Malignant Wound
Common in end-stage cancer
patients
Difficult to cure
Place of occurrence: breast,
chest wall or heck neck regions
Symptoms: exudates, pain,
malodor, pain and risk of
hemorrhage
(Ramasubbu et al., 2017)

Scope of the problem
5 to 10% of cancer patients in
the western countries become
victims of malignant wound
Since it occurs head-neck region
it goes unnoticed
Normal use of dressing is
ineffective to manage the wound
Effective anti-microbial therapy
will help to increase social and
psychological problems for
patients
(Lo et al., 2012)

Team of stakeholders
Stakeholders to be involved in the Change
management of wound care
The registered nurse
The change nurse
The occupational therapists
The medical officer
The pharmacist
A psychologist
Palliative care nurse
(Wai-man & Hospice, 2014)

Other stakeholders
include
Patient and their family
members
This is because it is
important for the care
members of the family and
the patients in know about
the reason of the procured
treatment and effective
outcome.
(Wai-man & Hospice, 2014)

Evidence to Support the Care
plan
Ramasubbu et al. (2017) conducted
systematic review on the randomized
control trial
They founded a single study at high risk of
bias
This highlighted metronidazole leads to the
reduction of malodor in patients with
malignant wound
The study can be said to be baised due to
sudden limitation due to its very small
sample size and focused only on patients
with breast cancer

Evidence to Support the Care plan
Watanabe et al. (2016) examined
21 patients of maiden age of 65
years
Administered 0.75 %
metronidazole gel
The rate of success of
deodorization at day 14 was
95.2 %
Treatment found to be well
tolerated with not significant side

Evidence to Support the Care
plan
Lian et al. (2014) proposed the use of
silver dressings for proper
management of antimicrobial activity
It helps in reducing septic
phenomena and malodor
Fromantin et al. (2014) stated that
effective management of MW deals
with careful cleaning of wounds
along with proper control of exudates

Action Plan
Desired outcomes: Significant
decrease in malodor
Measurement of the outcome:
Measurement of the odor score in
the scale of 0 to 1 after 2 weeks of
treatment
Key stakeholders will be reported
via presentations of the
documented results through power
point presentations

Action Plan (time table)
Tasks Time-frame
Education of nurse in relation
to malignant wound
management
1 week
Proper procurement of therapy 1 week
Evaluation of effectiveness of
therapy
2nd week after therapy
procurement
Scale of evaluation Odor scale
Dissemination of the
successful therapy via
PowerPoint presentation
among nursing professionals
outside the organization
1 month