Level of adherence to an extravasation protocol over 10 years in a tertiary care hospital

Clin J Oncol Nurs. 2015 Apr;19(2):E25-30. doi: 10.1188/15.CJON.E25-E30.

Abstract

Background: Extravasation of chemotherapy is an undesirable complication related to the administration of antineoplastic therapy. Establishing the real incidence is difficult. Because of the importance of a quick intervention after an extravasation, every hospital should have an extravasation protocol.

Objectives: The purpose of this study was to determine the degree of observance of an extravasation protocol by nursing staff and to determine extravasation incidence.

Methods: This descriptive, longitudinal, retrospective study was set in a tertiary-level hospital. The researchers reviewed 117 extravasation notification forms received by the pharmacy department during a 10-year period. Nursing actuation, particularly observance of the extravasation protocol, was analyzed.

Findings: Protocol adherence was 89%. Twelve deviations from the protocol in the application of recommended measures were detected. An antidote was used in 41 patients, and temperature measures were applied in 14 cases. Ninety-nine patients had at least one episode of reported follow-up. No cases of necrosis or skin ulcers were described, except by one patient, who developed a delayed skin ulcer to vinorelbine. Drugs most frequently reported were etoposide, carboplatin, and paclitaxel. Nursing staff should be continuously trained in extravasation protocol because a rapid actuation can prevent skin lesions.

Keywords: antineoplastic drugs; chemotherapy; extravasation protocol; oncology nursing.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Clinical Protocols*
  • Extravasation of Diagnostic and Therapeutic Materials / nursing*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spain
  • Tertiary Care Centers
  • Young Adult

Substances

  • Antineoplastic Agents