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Patient teaching on extravasation/infiltration

  • 1.  Patient teaching on extravasation/infiltration

    Posted 05-20-2019 16:14

    I am doing an evidence based project about whether doing specific pre-chemo teaching with patients on extravasation and infiltration can help these situations be discovered/reported more quickly and therefore be less harmful. Do any of you do specific teaching on this prior to chemo with your patients? And if so, do you use any certain teaching tool?

    Wendy Eash  RN, OIS
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  • 2.  RE: Patient teaching on extravasation/infiltration

    Posted 05-21-2019 09:45
    Hello every one, may I have a copy too. Please send it to


    Sarah Iranpour PMP
    Desk:202 (630) 0834
    Cell: 240 (505) 7272

  • 3.  RE: Patient teaching on extravasation/infiltration

    Posted 05-21-2019 10:11
    Hi. The article "Eliminating Extravasation Events: A Multidisciplinary Approach" mentions a tool and has a lot on patient education for extravasation, including the following four excerpts from separate parts of the article (patient education includes a description of the risk of tissue damage, use of a manikin or other visual teaching aids, etc.)

    The patient and caregiver must be informed about the risks related to the infusion of vesicants and irritants into peripheral veins. 14 In a busy oncology clinic setting, the completion of patient education before the first treatment can be challenging. Patients must be ready to hear in order to comprehend. New patient teaching about the diagnosis, the treatment plan, and the side effects of chemotherapy agents usually occurs at diagnosis. Information overload and the emotional aspects related to a cancer diagnosis frequently prevent the patient from hearing and understanding everything that is presented in a brief period of time (see Box 2). The concept of a CVAD may be difficult to understand in terms of function, placement, and daily living issues. The use of a manikin or other visual teaching aids can assist in clarifying vague concepts and can ease the decision-making process. A description of the risk of tissue damage also must be explained. The teaching must be reinforced with materials written at a sixth-grade reading level. 15 If the patient chooses peripheral access over a CVAD after the teaching, the patient needs to be reminded of the risks related to peripheral administration before every dose of the vesicant. 13 Detailed documentation of these conversations and teaching sessions is imperative. 3 The use of a guideline for vesicant administration ensures that up-front assessments allow for a safe administration plan on day 1 of treatment. In addition, the use of an evidence-based practice change ensures that multiple providers and staff members approach a challenging question using "the best" approach known to care.

    Patients who were to receive a drug classified as a vesicant or an irritant would have to be told in the educational session before treatment, and the potential risks would have to be verbalized by the patient and documented.

    Standardized patient education regarding the risks of chemotherapy administration. Documentation of the discussion with the patient about the characteristics of the agents and the risks involved with both peripheral and CVAD access is carried out, and printed patient education regarding vesicant chemotherapy with signs of extravasation is provided for reinforcement. The education is repeated each day of treatment.

    An initial assessment tool completed and documented when chemotherapy is planned and before the start of treatment. The tool, which is completed by the oncologist's RN in the electronic health care record (EHR), documents whether chemotherapy is planned, if a planned chemotherapy includes a vesicant, and the vein assessment ( Table 2 )

    Mark Vrabel
    Oncology Nursing Society
    Pittsburgh PA