Concept Paper

Introduction

Extravasation is defined as an inadvertent leakage of

chemotherapeutic agents from its intended vascular pathway

(Dougherty, 2013;Gibson et al., 2013). It is considered as a medical

emergency that has the potential to cause seriou disability,

diminish the patient’s quality of life, and leave nurses vulnerable

to the risk of malpractice claims. Intravenous therapy cannot be

separated from complications. Complications that can be obtained

from intravenous therapy are systemic complications and local

complications. Systemic complications are less common but are often

more serious than local complications such as circulatory overload,

air embolism, and infection. Local complications of intravenous

therapy include infiltration, phlebitis, thrombophlebitis, hematoma,

and extravasation. Risk factors that can lead to the extravasation

of chemotherapy drugs with peripheral intravenous administration are

edema, vascular location, chemotherapy drug type, radiation scar,

venous weakness, reduced vascular integrity resulting in reduced

elasticity, edema, trauma, drug concentrations cytostatic, number of

infiltrated drugs and long tissues exposed to drug infiltration.

This can harm patients because it can cause burns, pain, infection

risk, dysfunction and can cause permanent damage. 0.9% NaCl is an

isotonic liquid that is physiological, non-toxic and

nonhypersensitivity so it is safe to use for the body under any

circumstances, no irritant protects tissue granulation from dry

conditions, keeps moisture around the wound and helps the wound go

through the healing process. giving a 0.9% NaCl compress on the

wound can decrease the symptoms of edema because normal saline

fluids may draw fluid from the wound through the osmosis process. In

addition, 0.9% NaCl has an anti-inflammatory response that can

reduce the symptoms of pain and erythema that arise in the wound,

and Advances in Health Science Research, volume 6 605 increase blood

flow to the wound area, thus accelerating the wound healing process.

Body

The cost of treatment with chemotherapy is very expensive.

Therefore, the provision of cytostatic drugs should pay attention to

several things such as chemotherapeutic drugs, knowledge of nurses

in administering chemotherapy and most importantly the selection of

venous access sites and patency of venous. Extravasation adds to the

patient's pain, medical expenses, and can extend the patient's

hospitalization time. This research must have the inclusion criteria

are (1) patients willing to be a respondent, (2) patients undergoing

chemotherapy, (3) patients using vesican drugs, (4) patients who use

irritant drugs, (5) chemotherapy drug administration time <24 hours

and >24 hours, (6) patients who can communicate. The exclusion

criteria are patients who use neutral drugs and unconscious

patients. The tools for data collection includes are the observation

sheet from signs on extravasation and mark on the sheet if there is

a sign come up on patients and Extravasation Scale sheets, adopted

from Infusion Nurses' Society (2006), it was filled by the studied

nurses to assess signs of infiltration at the intravenous site for

patients during administration chemotherapeutic agents. The scale

parameters namely: skin color, integrity, temperature, edema,

mobility, pain and fever. It was graded from zero to four according

to the clinical criteria.

The present study hypothesized that there is an effect of NaCl

compresses to prevent extravasation in chemotherapy patients during

drug administration time <24 hours and >24 hours implementation of

nursing interventions model.

Conclusion

The cost of treatment with chemotherapy is very expensive.

Therefore, the provision of cytostatic drugs should pay attention to

several things such as chemotherapeutic drugs, knowledge of nurses

in administering chemotherapy and most importantly the selection of

venous access sites and patency of venous. Especially, for

government hospital in my city their very concerned about the

extravasation in the hospital are not expected to happen because the

hospital should be able to provide safety and uncomplicated services

to prevent extend hospitalization time.