降低化療集中病房化學治療藥物外滲率

Reducing the Chemotherapy Extravasation Rate in A Centralized Chemotherapy Ward

外滲是接受化學治療的重要意外事件，「預防發生」是照護最重要的策略。本專案在降低化療集中病房化學治療藥物外滲率；調查發現病人對化學治療過程外滲及管路安全認知得 61.7 分，異常事件 3 件；原因為教導內容不符合需求、忘記、缺乏適當輔具、對內容不清楚、未確實指導化學治療管路安全維護等。修訂化學治療給藥照護規範、新增化學治療期間預防藥物外滲及管路安全護理指導單張及配合 QR Code、新增預防藥物外滲及管路安全護理指導影片和海報、定期舉辦團體護理指導、納入新進人員學習手冊、定期監測病人對化學治療過程外滲及管路安全認知程度等，病人化學治療過程外滲及管路安全認知提升為 100 分，異常事件降低為 0 件，進而提升癌症整體照護品質，可作為類似單位參考。

Extravasation is a critical accidental event that occurs while administering chemotherapy, and thus, accident prevention is a necessary and vital strategy in medical care. In this study, the patient awareness score for chemotherapy extravasation and tubing safety was 61.7 points. Three abnormal events occurred, and deficiencies consisted of possessing irrelevant educational information, forgetting what has been taught, lacking adequate aids, having questions about the educational information, and lacking a reliable security system for the chemotherapy tubing safety. To improve patients’ awareness regarding chemotherapy extravasation and tubing safety to 100 points and prevent abnormal events, the following strategies should be implemented: standard guidance should be set for chemotherapy administration, a nursing care educational card with a QR code should be developed to prevent extravasation during chemotherapy administration and ensure tubing safety, a nursing care educational video and posters concerning the prevention of extravasation during chemotherapy administration and tubing safety should be developed, nursing care group seminars should be regularly conducted, related information should be incorporated into the newcomer training manual, and the awareness level of patients regarding chemotherapy extravasation and tubing safety should be regularly monitored. These strategies can increase overall cancer care quality, thus serving as a model for other similar wards.