Effect of Educational Program on Nurses' Performance Regarding Prevention and Management of Intravenous Extravasation Chemotherapy

Abstract

Context: Systemic chemotherapy plays a pivotal role in curative therapy for patients with hematological neoplasms and several types of advanced solid tumors. Extravasation describes an anticancer agent's accidental leakage from a vessel into the surrounding tissues, leading to irreversible local injuries and severe disability. Despite its considerable clinical importance, evidence-based information on extravasation in chemotherapy is lacking.
 Aim: This study aimed to evaluate the effect of an educational program on nurses' performance regarding the prevention and management of intravenous extravasation chemotherapy.
 Methods: The following hypotheses were formulated to achieve the study aim. H1: Nurses' performance related to the prevention and management of intravenous extravasation chemotherapy will be improved after implementing the educational program compared to the pre-program. H2: There will be a significant correlation between nurses’ knowledge and practice post-program implementation. A quasi-experimental research design was utilized to conduct the current study in the oncology unit at Benha University Hospital. A convenience sample consisted of all available nurses (n=40) working in the oncology unit were recruited to achieve the aim of this study. Two tools were used, the nurses' knowledge assessment questionnaire and the nurses' practice observational checklist regarding the prevention and management of intravenous extravasation chemotherapy.
 Results: This study shows that most nurses had an unsatisfactory level of total knowledge and inadequate total practice regarding the prevention and management of intravenous extravasation chemotherapy pre-program implementation (85% and 56%). This result improved significantly regarding all knowledge and practice elements immediately post-program implementation, where the majority of the nurses had a satisfactory level of their total knowledge and adequate total practice (95% and 94%) that was slightly decreased three months after program implementation (75%) for both knowledge and practice.
 Conclusion: The majority of the nurses surveyed had an unsatisfactory performance level (knowledge and practice) concerning the prevention and management of intravenous extravasation chemotherapy pre-program implementation. In contrast, most of the studied nurses had statistically significant improvement in their performance immediately and after three months from program implementation, which supported the current study hypotheses. The study recommended continuous in-service training programs and establishing guidelines to help the oncology nurses revise, acquire, and develop their knowledge and practice regarding preventing and managing intravenous extravasation chemotherapy.

Enhancement of Oncology Nurses' Competency Regarding Management of Intravenous Chemotherapy Extravasation

“…This part of tool was adapted from (Binner, Ross, & Browner, 2011 ;El-Fadl, 2020 ;Fidalgo et al, 2012). It was used to assess nurses' knowledge regarding chemotherapy and extravasation preposttest.…”

“…Total knowledge score level was converted into percentage and categorizes into: ≥70% (answered≥ 40 questions)considered satisfactory level of knowledge. <70% (answered ‹ 40 questions )was considered as an unsatisfactory level of knowledge (El-Fadl, 2020). Tool2:Nurses' Practice Observational Checklist.…”

“…Part 2 was adapted from (Binner, Ross, & Browner, 2011;El-Fadl, 2020;Fidalgo et al, 2012).  Tool 2 was developed by the researcher based on a review of recent related literature.…”