Spill and extravasation of antineoplastic chemotherapics in a university hospital

Authors

DOI:

https://doi.org/10.33448/rsd-v9i7.4320

Keywords:

Spill; Extravasation; Incidence; Chemotherapy.

Abstract

Spill and leakage stand out as rare and important adverse events in chemotherapy due to their risks. This study aims to determine the incidences and characterize these events, considering their determinants, patient profile and management according to the institutional protocol. This is a retrospective documentary, descriptive and transversal research, with a quantitative approach, carried out in an institution in Belém-Pará. Data collection covered the period from 2012 to 2019, subsidized by reading order and occurrence books, patient records and filling out a specific instrument. The data were structured in Microsoft Excel 2019 for descriptive and statistical analysis using the Chi-square test with p value <0.001 and the kolmogorov-smirnov test. 26 cases of spillage and 41 leakage were analyzed in 55 patients. The incidences of spillage and leakage were 0.08 and 0.13, respectively. Irritating antineoplastic drugs were more frequent in cases of spillage and vesicants had a higher rate in extravasation events, with emphasis on Paclitaxel. The follow-up to the institutional protocol was the majority, however, the measures were not recorded in detail in the medical records. The differential of this research was the joint analysis of the overflow and spill events, showing their concomitance. It is emphasized that the risks of these AEs must be monitored and duly notified, mainly by nursing professionals, aiming at the quality of health care, as well as the safety of professionals, patients and family members.

References

Abd El-Salaheena MH, Ahmedb BO & Mahmoud AS. (2018). Correlates to extravasation among patient receiving chemotherapy at a university hospital. Egyptian Nursing Journal, 15 (1), 71-8.

ANVISA. (2017). Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Brasília: ANVISA.

Brasil. (2014). Portaria nº 140, de 27 de fevereiro de 2014. Brasília: Ministério da Saúde. Acesso em: 17 maio 2020. Disponível em:

http://bvsms.saude.gov.br/bvs/saudelegis/sas/2014/prt0140_27_02_2014.html

Boulanger J, Ducharme A, Dufour A, Fortie S & Almanric K. (2015). Management of the extravasation of anti-neoplastic agentes. Support Care Cancer, 23:1459–71.

Connor TH, DeBord DG, Pretty JR, Oliver MS, Roth TS, Lees PSJ & McDiarmid MA. (2010). Evaluation of Antineoplastic Drug Exposure of Health Care Workers at Three University-Based US Cancer Centers. JOEM, 52(10): 1019-27.

Conselho Federal de Enfermagem (Cofen) (2018). Resolução Nº 569. Regulamento Técnico da Atuação dos Profissionais de Enfermagem em Quimioterapia Antineoplásica. Disponível em: http://www.cofen.gov.br/resolucao-cofen-no-0569-2018_60766.html.

Ferreira AR, Ferreira EB, Campos MCT, Reis PED & Vasques CI. (2016). Biosafety Measures in Chemotherapy Administration: Nurses’ Knowledge Medidas de Bioseguridad en Administración de Quimioterapia: Conocimiento de los Enfermeiros. Revista Brasileira de Cancerologia, 62(2): 137-45.

Ferrari LAM, Dinoi GL, Saibene G, Re B, Balzarini A, Giordano L & Bregant C. Cytotoxy extravasation: na issue disappearing or a problem without solution?. Tumori, 102(3):290-93.

Friese CR, McArdle C, Zhau T, Sun D, Spasojevic I, Polovich M & McCullagh MC. Antineoplastic Drug Exposure in an Ambulatory Setting: a Pilot Study. Cancer Nurs, 38(2): 111–17.

He BY, Mendelsohn-Victor K, McCullagh MC & Friese CR (2017). Personal Protective Equipment Use and Hazardous Drug Spills Among Ambulatory. Oncology Nurses Oncology nursing fórum, 44 (1). 60–5.

Hospital Universitário João de Barros Barreto (HUJBB). (2012). Procedimentos Operacionais Padrão do Serviço de Oncologia Clínica. Unidade de Assistência de Alta Complexidade em Oncologia.

Hospital Universitário João de Barros Barreto (HUJBB). (2016). Procedimentos Operacionais Padrão do Serviço de Oncologia Clínica. Unidade de Assistência de Alta Complexidade em Oncologia.

Jackson-Rose J, Del Monte J, Groman A, Dial L, Atwell L, Graham J & Rice RD. (2017). Chemotherapy Extravasation Establishing a national benchmark for incidence among cancer centers. Clinical Journal of Oncology Nursing, 21(4): 1-8.

Molas-Ferrer G, Farré-Ayuso E, Pazo-Oubiña F, Andrés-Lázaro A, Guell-Picazo J, Borrás-Maixenchs N & Creus-Baró N. (2015). Level of Adherence to an Extravasation Protocol Over 10 Years in a Tertiary Care Hospital. Clinical Journal of Oncology Nursing, 19(2): 25-9.

Murayama R, Oya M, Abe-Doi M, Oe M, Komiyama C & Sanada H. (2019). Characteristics of subcutaneous tissues at the site of insertion of peripheral infusion in patients undergoing paclitaxel and carboplatin chemotherapy. Drug Discoveries & Therapeutics.,13(5):288-93.

Na Z, Qiaoyuan Y, Binghan W, Qin Z, Yue C, Xin P & Cheng Y. (2017). A developed model of cancer patients participation in intravenous chemotherapy safety. Oncotarget, 8(50).

National Health Service (NHS) England. (2020). Guideline for management of extravasation. Disponível em: http://www.eastmidlandscanceralliance.nhs.uk/downloads/documents/

Chemotherapy/Policies__Guidelines/Extravasation_03052018.pdf.

Onesti MG, Carella S, Fioramonti P & Scuderi N. Chemotherapy Extravasation Management 21-Year Experience. Annals of Plastic Surgery, 79 (5): 450-57.

Pereira AS, Shitsuka DM, Parreira FJ & Shitsuka R. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM. Acesso em: 16 maio 2020. Disponível em: https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao _Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Sakaia E, Sekine I, Iwasawa S, Kurimoto R, Uehara T, Ooka Y, Akanuma N & Takiguchi Y. (2014). Incidence, Risk Factors and Treatment Outcomes of Extravasation of Cytotoxic Agents in an Outpatient Chemotherapy Clinic. Jpn. J. Clin. Oncol.,44(2):168–71.

Silva MO, Holanda MA & Silva TMS. (2019). Derramamento de drogas antineoplásicas na sala de quimioterapia do hospital universitário professor alberto antunes – hupaa. GEPNEWS, Maceió, 2(2):367-74.

Souza NR, Bushatsky M, Figueiredo EG, Melo JTS, Freire DA & Santos ICRV. (2017). Escola de Enfermagem Anna Nery, 21(1).

Published

30/05/2020

How to Cite

SAGICA, T. dos P.; CONCEIÇÃO, C. de M.; FERREIRA, J. V. S.; ALBUQUERQUE, G. P. X.; COSTA, M. S. C. R.; SOARES, H. C. B.; RAMOS, A. M. P. C. Spill and extravasation of antineoplastic chemotherapics in a university hospital. Research, Society and Development, [S. l.], v. 9, n. 7, p. e552974320, 2020. DOI: 10.33448/rsd-v9i7.4320. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/4320. Acesso em: 25 nov. 2024.

Issue

Section

Health Sciences