Clamp for Safety: Improving Intravesical Chemotherapy Practices

Area of Science:

• Urology
• Oncology
• Healthcare Quality Improvement

Background:

• Intravesical chemotherapy administration post-transurethral resection for nonmuscle invasive bladder tumors often lacks standardized protocols.
• Chemotherapeutic agent spills from urinary catheters were reported, highlighting safety concerns.
• Inadequate adherence to personal protective equipment (PPE) guidelines for handling hazardous medications was observed.

Purpose of the Study:

• To enhance the safety and standardization of intravesical chemotherapy delivery.
• To identify and implement a cost-effective device for securing chemotherapy within the bladder.
• To improve adherence to PPE protocols during chemotherapy administration.

Main Methods:

• A quality improvement project was initiated following incident reports of chemotherapy spills.
• A literature review and observational assessment informed process revisions.
• A cost-effective clamping device and recommended PPE were procured and implemented.
• Staff received training on the new clamping procedure and PPE usage.

Main Results:

• The implementation of a revised process, including a novel clamping device and enhanced PPE protocols, led to zero spills.
• No spills associated with intravesical chemotherapy occurred across four surgical locations post-implementation.
• Improved standardization and safety in chemotherapy administration were achieved.

Conclusions:

• A standardized, cost-effective approach using a specialized clamp and appropriate PPE effectively prevents intravesical chemotherapy spills.
• Quality improvement initiatives are vital for enhancing patient safety in urologic oncology procedures.
• Adherence to safety protocols, including proper equipment and PPE, is essential when administering hazardous medications.