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Level of Adherence to an Extravasation Protocol Over 10 Years in a Tertiary Care Hospital

Gloria Molas-Ferrer

Elisabet Farré-Ayuso

Fernando doPazo-Oubiña

Ana deAndrés-Lázaro

Jaume Guell-Picazo

Núria Borrás-Maixenchs

Lourdes Corominas-Bosch

Montserrat Valverde-Bosch

Natalia Creus-Baró

extravasation protocol, chemotherapy, oncology nursing, antineoplastic drugs
CJON 2015, 19(2), E25-E30. DOI: 10.1188/15.CJON.E25-E30

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.

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