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

<h3>Background and Importance</h3> 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. <h3>Aim and Objectives</h3> To determine the prevalence, nature and deployed management strategies of extravasations in hospitalised patients and to assess patient-reported outcomes post-discharge. <h3>Material and Methods</h3> 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. <h3>Results</h3> 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. <h3>Conclusion and Relevance</h3> 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. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest