Preventing chemotherapy drug extravasation in adults from the general surgery ward: a best practice implementation project.

Abstract

Introduction: Chemotherapy drug extravasation (CDE) is a well-documented complication associated with a significant potential for severe adverse outcomes.

Objective: This project aimed to implement evidence-based strategies to prevent CDE in hospitalized adults in the general surgery ward.

Methods: This project used the JBI Evidence Implementation Framework, together with the JBI Practical Application of Clinical Evidence System (PACES) system. A baseline audit was conducted with 27 nurses and 30 patients, using six evidence-based criteria to measure initial compliance with best practices. JBI's Getting Research into Practice (GRiP) approach was then used to identify barriers and implement strategies, including objective structured clinical examination (OSCE), medium fidelity simulation (MFS), interprofessional education, and patient-centered educational materials. A follow-up audit was then conducted to assess improvements in compliance with best practices following the intervention.

Results: The baseline audit revealed compliance rates ranging from 3%-76% for the six criteria. Following the implementation of best practices, all six criteria rose to 93%-100% compliance. Moreover, nursing staff demonstrated improvements in knowledge and skills related to CDE. Importantly, no cases of CDE were reported during the post-implementation period.

Conclusions: This project highlights the importance of improving nurses' competency in CDE management through OSCE and MFS. Additionally, the development of patient-centered educational materials enhanced patients' understanding of chemotherapy extravasation risks, thereby contributing to improved patient safety and quality of care.

Spanish abstract: http://links.lww.com/IJEBH/A480.