Audit on incidents and knowledge of nurses regarding chemotherapy extravasations at day care oncology of a tertiary care hospital in Karachi, Pakistan

Document Type



Community Health Sciences; Medicine; Haematology/Oncology


Purpose: Extravasations of cytotoxic agents after intravenous administration results in serious damage to the tissues leading to local injury and tissue necrosis. Worldwide incidence of extravasation ranges from 0.1% – 6%. Patient education, early identification and management can reduce morbidity associated with chemotherapy extravasation.
Method: This audit was conducted at day care oncology of Aga Khan University Hospital to assess the knowledge of nursing staff regarding identification, management and teaching to the patients about of chemotherapy extravasations before and after teaching (intervention) sessions. These sessions were conducted monthly, for a year (July 2016 till June 2017). We also recorded incidents of extravasation reported before (February till June 2016) and after (July till November 2017) intervention.
Results: A total of twelve nurses were audited before and after the intervention. Their mean age was 36.08 years ±3.35 (range 32-42 years). They had median 5 years’ (range 1-13 years) experience at Daycare Oncology. Overall, 63% and 96% had demonstrated and answered the steps of identification and management correctly in audit before and after intervention respectively (P<0.001). Incidence of chemotherapy extravasation was 0.128% (7/5461) and 0.054% (3/5546) before and after intervention. In total, vinorelbine was the most common drug associated with such incidence (50%). Most had grade II reaction (50%) and history of chemotherapy (70%) was the most common risk factor.
Conclusion: Our hospital based incidence of chemotherapy extravasation is comparable to international data. This may be reduced further by improving knowledge of nurses regarding prevention, prompt identification, management and education of patients.


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Journal of Oncology and Cancer Research