ORLANDO, FL—A newly designed electronic extravasation assessment form that links nursing informatics and quality to practice has resulted in better patient care and more robust research, according to a presentation at the ONS 40th Annual Congress.
Extravasation, an uncommon but potentially debilitating side effect of chemotherapy, results in tissue, muscle, and nerve injury; poor patient outcomes; and decreased quality of life.
“On average, we administer approximately 74,000 prescribed vesicant and irritant chemotherapy doses in a year, of which approximately 94 result in suspected or actual extravasations,” noted Leticia T. Smith, MSN, FNP-BC, OCN®, Memorial Sloan Kettering Cancer Center, New York, New York.
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In 2012, the cancer center amended its Extravasation Assessment Form to be more comprehensive and user friendly.
As a result, adherence for many aspects of the extravasation follow-up policy have improved. In this presentation, Smith describes how nurse clinicians partnered with nursing informatics to convert the form to an electronic tool, further improving documentation of follow-up procedures.
“Standardization of practice across the inpatient and outpatient care continuum through automation allows for less fragmented care and provides a process to measure compliance, nursing interventions and outcomes,” said Smith.
Advantages of the tool include a “copy forward” feature for information surrounding the initial event, this prevents transcription errors; a “track patient progress” document connects to the event reporting system via electronic order entry; and nurses are prompted to perform follow-up assessments as well as documentation requirements necessary for adherence.
Metrics include improved reporting, standardized data collection, and analysis. To date, data analysis demonstrates documentation of interventions, patient education, assessments, and discharge from follow up have improved. “Better documentation leads to better outcomes for patients,” said Smith.
