4CPS-025 Medication extravasation management and outcomes in patients who experienced an extravasation of medication during hospital admission: a mixed-method study

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Background and Importance Intravenous (IV) medication administration, a routine procedure in hospitalised patients, carries risks of complications such as extravasations. Extravasations, the unintentional leakage of a vesicant drug into surrounding tissue, can result in tissue damage and necessitates prompt intervention. Current literature lacks comprehensive data on the prevalence, management and patient outcomes associated with extravasations. Aim and Objectives To determine the prevalence, nature and deployed management strategies of extravasations in hospitalised patients and to assess patient-reported outcomes post-discharge. Material and Methods A single-centre, retrospective, mixed-method study. All admitted patients who experienced extravasations between 1 January 2022 and 1 January 2024 were included. Eligible patients were invited to complete a questionnaire. Primary outcome: prevalence and nature of extravasations, including deployed management strategies. Secondary outcomes: patients’ outcomes after extravasation post-discharge, including their experiences regarding the extravasation during and after admission. Data were extracted from the Electronical Health Record (EHR) system and questionnaires were analysed using descriptive statistics. Results We included 200 patients with 205 extravasations, yielding a prevalence of 0.014% (of IV administrations). Among the 74 drugs involved, anti-infectives were most common (32.7%). Peripheral parenteral nutrition was most frequently extravasated, both in absolute numbers (n=19), as in relation to its number of administrations (4.2%), followed by acyclovir (n=11 and 0.5% resp.). Extravasations predominantly occurred in the arm (61.5%) and were of moderate severity. Symptoms were most prevalent on day 1 and often disappeared in 2–3 days. Top 3: swelling (70.8%), redness (40.9%) and pain (38.5%). Standard management strategies were applied in 96.6% of cases. Drug-specific management strategies particularly encompassed cold compresses alone n=69 (33.7%) and hot compresses with hyaluronidase n=65 (31.7%). The patient questionnaire (n=41) revealed that 70.7% of patients mainly recalled experiencing swelling, pain and redness. A burning feeling was recollected far more often than was documented in the EHR: n=19 (46.3%) versus n=1 (0.6%). Less than half of patients indicated that treatment led to a reduction in symptoms. Post-discharge, 34.1% continued to suffer from symptoms. Conclusion and Relevance This study is the first to comprehensively assess prevalence, nature, deployed management strategies and patient outcomes after extravasation. The results indicate room for improvement in management strategies and patient follow-up after extravasation. References and/or Acknowledgements Conflict of Interest No conflict of interest

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