Managing Cytotoxic Extravasation: Simulation-based tutorials to improve quality of care and patient safety for chemotherapy patients.

This paper reports on a quality improvement project that was conducted collaboratively by an oncology clinical nurse coordinator and simulation nurse educator. The project utilized simulation- based tutorials with a stepwise approach to train and evaluate the self-efficacy of oncology registered nurses working in a tertiary care hospital. A general assessment of the problem of cytotoxic extravasation was explored using an Ishikawa diagram and the factors responsible for such common issues in chemotherapy administration and oncology nursing practice were plotted. The Plan- Do-Study-Act (PDSA) approach was utilized to apply the quality improvement project method and to strategize the learning for the oncology nurses. The simulation tutorials approach used was an innovative educational activity. The project was completed by training each oncology registered nurse to enhance their efficacy in identifying and managing extravasation. The innovation of simulation-based education tutorials was effective in enhancing nurses' practices. It also provided insight for continuous nursing education and evaluation that will impact the clinical practice routines in oncology care, thus saving patients from potential adverse effects of chemotherapy.