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Challenging the distal-to-proximal cannulation technique for administration of anti-cancer therapies : a prospective cohort study

Chan, Raymond Javan, Alexander, Alison, Bransdon, Maree, Webster, Joan, Hughes, Brett Gordon Maxwell, Brown, Leisa, & Graham, Therese (2012) Challenging the distal-to-proximal cannulation technique for administration of anti-cancer therapies : a prospective cohort study. Cancer Nursing, 35(5), e35-40.

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Abstract

Background: Distal-to-proximal technique has been recommended for anti-cancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous uncomplicated venous puncture proximal to the administration site.
Objectives: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anti-cancer therapies at a distal site is necessary for preventing extravasation. Methods: A prospective cohort study was conducted with 72 outpatients receiving anti-cancer therapy via an administration site distal to at least one previous uncomplicated venous puncture on the same arm in a tertiary cancer centre in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. Results: Of 72 participants with 99 occasions of treatment, there was one incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and two incidents of phlebitis at the administration site. Conclusions: A 24 hour delay is unnecessary if an alternative vein can be accessed for anti-cancer therapy after a proximal venous puncture. Implications for practice: Extravasation can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anti-cancer therapy at a distal site if the nurse can confidently determine the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.

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ID Code: 46134
Item Type: Journal Article
Keywords: cannulation technique , chemotherapy, anti-cancer therapies, cancer nursing, infiltration, phlebitis, extravasation
DOI: 10.1097/NCC.0b013e3182352916
ISSN: 0162-220X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > ONCOLOGY AND CARCINOGENESIS (111200) > Chemotherapy (111205)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2011 Lippincott, Williams & Wilkins.
Deposited On: 26 Sep 2011 10:44
Last Modified: 07 Nov 2013 01:57

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