Implementing guidelines for managing extravasation of antineoplastics

The development and implementation of guidelines for managing extravasation of antineoplastics in a community teaching hospital are described. Guidelines outlining general and specific treatment measures for extravasation of antineoplastic agents were prepared with the cooperation of the medical, pharmacy, and nursing staffs. These guidelines were incorporated into policies and procedures allowing nurses on the oncology unit to administer i.v. push antineoplastic agents and manage extravasations of these drugs; on other units, physicians were responsible for administering these drugs and managing extravasations. Monographs containing information about administering injectable antineoplastics were compiled in a manual and placed on nursing units as a reference source. An extravasation treatment kit was also prepared by the pharmacy and distributed to the nursing units; kits were exchanged and charged in a manner similar to that used for emergency-code carts. Physicians, nurses, and pharmacists were informed about the extravasation management guidelines and treatment kits through inservice-education programs, newsletters, and staff meetings. A quality-assurance program to monitor process and outcome associated with the use of the guidelines was initiated. Multidisciplinary involvement in the development of extravasation management guidelines for antineoplastic agents used in this hospital ensures prompt and uniform treatment of these adverse reactions.