Extravasamento de quimioterápicos antineoplásicos: conhecimento dos enfermeiros e estratégias para um cuidado seguro

Abstract

The discovery of antineoplastic drugs revolutionized cancer treatment; however, their use involves risks such as extravasation, which can cause severe tissue injury. Nursing plays a crucial role in preventing and managing this event through appropriate venous access selection and continuous monitoring to enable immediate intervention. Nurse training and the implementation of a Standard Operating Procedure (SOP) are essential to ensure patient safety and the effectiveness of oncological treatment, reducing complications and improving care quality. This is a descriptive and exploratory study with a quantitative and qualitative approach. The objective was to investigate nurses’ knowledge regarding the administration of antineoplastic chemotherapeutic agents, focusing on strategies used to prevent and manage extravasation of these drugs. The classification of antineoplastic drugs yielded 132 errors compared to 108 correct answers. Regarding signs of extravasation, although 100% of nurses mentioned subjective manifestations such as pain and burning, none cited crucial mechanical signs for early detection, such as drip interruption, absence of venous return, or infusion resistance. Proficiency in basic and immediate post-extravasation care was highly concerning, as no nurse achieved a 100% score, and two participants failed all basic conduct items. Concerning risk factors, drug type was the most frequently cited (100%), followed by fragile venous network and patients’ neurological conditions (63.6% and 63.3%, respectively). Knowledge regarding the correct sequence for venous puncture was found to be deficient. The lack of familiarity with the protocol and the low accuracy in classifications and immediate interventions indicate a risk to oncological patient safety. Therefore, the findings highlight the urgent need to implement a Continuing Education Program focused on technical competence, early detection of mechanical signs, and rigorous standardization of the post-extravasation workflow, along with formal updates and oversight of the unit’s Standard Operating Procedure (SOP) to ensure oncological patient safety