Extravasation campaign aims to highlight best practice

NHS trust launches online survey to record and learn more about intravenous medication incidents across the UK

An NHS trust is aiming to improve the management of extravasations across the UK by filling a gap in national reporting with an online survey.

Extravasation occurs when a patient is receiving intravenous medication and it leaks from a cannula or other device, or from the vein, into the surrounding tissue. The effects can range from mild skin irritation to severe necrosis.

Northern Devon Healthcare NHS Trust has launched a campaign to record and learn more about extravasation incidents, led by its acute oncology service lead and interim lead cancer nurse Emma Thoms and the trust’s lead cancer pharmacist Nyasha Manomano.

They have taken the initiative to fill a gap left by the national green card scheme, previously used by hospitals to report extravasations but removed three years ago.

Ms Thoms said the trust decided to launch a web-based survey to collect information on extravasations, and to share best practice based on the evidence collated.

‘We will review the data, analyse the trends and risk factors, and publish the findings so we can improve practice across the country.’

She said while extravasations are rare, they can significantly affect a patient’s quality of life.

The survey allows healthcare professionals to record details of when an extravasation occurred, what drug was being used, how much leaked, the type of device being used and the treatment being provided.

RCN professional lead for long-term conditions Amanda Cheesley welcomed the campaign and said it may determine how consistent the approaches to extravasations are across NHS trusts.

‘Finding out how common extravasations are would be a good thing,’ she said.

A Medicines and Healthcare Products Regulatory Agency (MHRA) spokesperson said: ‘To date nothing has replaced the green card scheme and it is our understanding that such episodes are reported at a local level.’

He added that issues with medicines and devices related to extravasations could be reported via the MHRA’s yellow card scheme, and it monitors data on devices for safety issues.

Ms Thoms’ recommendations for nurses providing IV therapy include:

Check that the patient is cannulated properly and the right cannula or device has been used.

Always use a new cannula, for example, if switching from giving a patient IV fluids to chemotherapy medication.

Ensure patients know about the risk of extravasation.

Further information:

Northern Devon Healthcare NHS Trust extravasation survey