Eliminating extravasation events: a multidisciplinary approach.
Administration of chemotherapy agents can give rise to many safety issues. Extravasation of a vesicant agent causes tissue blistering and necrosis. This complication of chemotherapy administration causes additional pain and suffering in patients who are already suffering with a diagnosis of cancer. Nurses hold key responsibilities for educating patients about administration issues and following practice standards to minimize the risk of extravasation. Defining a path of shared responsibilities among team members is a critical step in assuring the safe administration of drugs classified as vesicants. This article describes a clinical practice change that is used at a large midwestern academic medical cancer center. This practice and policy change has resulted in a 90% reduction in the administration of vesicant agents peripherally, with no occurrence of extravasations in the first 6 months of implementation.
Froedtert Lutheran Memorial Hospital Clinical Cancer Center, Milwaukee, Wisconsin. Christine E. Coyle, MSN, RN, OCN®, is a nurse educator at the Clinical Cancer Center-Day Hospital at Froedtert Lutheran Memorial Hospital in Milwaukee, Wisconsin. Her role is to improve nursing practice through standardization of continuing education and training for the specialty of oncology. Julie Griffie, MSN, RN, AOCN®, ACNS-BC, APRN, is the manager of nursing practice for the Clinical Cancer Center at Froedtert Lutheran Memorial Hospital in Milwaukee, Wisconsin. She has been a clinical nurse specialist for more than 30 years, specializing in oncology. She has written a number of publications related to nursing practice standards. Lynn M. Czaplewski, MS, RN, ACNS-BC, CRNI®, AOCNS®, is a clinical nurse specialist for the Cancer Center-Day Hospital at Froedtert Lutheran Memorial Hospital in Milwaukee, Wisconsin. She served as president of the Infusion Nurses Society from 2006 to 2007 and has been named CRNI® of the Year.
Christine E
CE
Coyle
Julie
J
Griffie
Lynn M
LM
Czaplewski
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000517:prevention & control*; D006801:Humans; D007318:Inservice Training; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing; D040242:Risk Reduction Behavior
D000970:Antineoplastic Agents