POST BURN PRURITUS RELIEF PROTOCOL

Post burn pruritus is pervasive, occurring in over 90% of burn patients. Moreover, post burn pruritus continues in greater than 40% of patients for years even after burn wounds are healed. Post burn pruritus is a syndrome of stressful symptoms experienced by burn survivors that requires medical management with effective interventions. Unfortunately, many burn patients suffer from pruritus-related post burn injury regardless of current standard therapies. Therefore, in this Doctor of Nursing Practice project, published evidence including studies/reviews of post burn pruritus relief served as a basis for development of an advanced practice nurse (APN)-driven post burn pruritus relief protocol. A systematic review was conducted and relevant empiric articles from September 1, 2013 to November 17, 2014 were critically appraised. Initially, 79 articles were found; 38 articles were selected using pre-established inclusion criteria. Two frameworks were used to guide this project. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model was applied for the literature review and the Rosswurm and Larrabee’s model for evidence-based practice change was used for clinical application. The newly developed APN driven post burn pruritus protocol is driven by burn healing phase (pre-healing, healing, post-healing), and emphasizes non-pharmacological interventions; it includes both non-pharmacological and pharmacological methods specifically intended for reducing burn associated pruritus.