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Cancer Nursing:
doi: 10.1097/NCC.0b013e3182352916
Articles: Online Only

Challenging the Distal-to-Proximal Cannulation Technique for Administration of Anticancer Therapies: A Prospective Cohort Study

Chan, Raymond Javan MAppSc (Research), BN, RN, FRCNA; Alexander, Alison RN; Bransdon, Maree MN, RN; Webster, Joan BA, RN, RM; Hughes, Brett Gordon Maxwell MBBS(Hons), BSc(Med), FRACP; Brown, Leisa MN, BN, RN; Graham, Therese BN, RN

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Abstract

Background: Distal-to-proximal technique has been recommended for anticancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous 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 anticancer therapies at a distal site is necessary for preventing extravasation.

Methods: A prospective cohort study was conducted with 72 outpatients receiving anticancer therapy via an administration site distal to at least 1 previous venous puncture on the same arm in a tertiary cancer center 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 1 incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and 2 incidents of phlebitis at the administration site.

Conclusion: A 24-hour delay is unnecessary if an alternative vein can be accessed for anticancer therapy after a proximal venous puncture.

Implications for Practice: Infiltration can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anticancer therapy at a distal site if the nurse can confidently determine that the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.

© 2012 Lippincott Williams & Wilkins, Inc.

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