Knowledge Bank

Background: Hypersensitivity reactions are common in oncology infusion units where high-risk chemotherapy/immunotherapy treatments are given. Establishing clinical guidelines for the management of hypersensitivity reactions is important to ensure reactions are managed appropriately. Purpose: The purpose of this project was to accurately identify and rank the severity of chemotherapy/immunotherapy-induced hypersensitivity to reduce overtreatment with epinephrine as a rescue medication for suspected hypersensitivity infusion reactions. The objectives were 1) determine the frequency of epinephrine used as a rescue medication to treat a hypersensitivity reaction as a result of a chemotherapy/ immunotherapy infusion for people diagnosed with cancer and 2) evaluate the compliance in completion of event reports correlating with the actual number of hypersensitivity reactions occurring after the administration of chemotherapy/immunotherapy in the patient safety reporting system before and after the intervention. Methods: The quality improvement project was implemented on a 15-bed oncology infusion unit staffed by seven nurses. An evidence-based decision tree tool was utilized to educate staff in the effective management of hypersensitivity reactions. Education was provided on the importance of reporting hypersensitivity reactions in the patient safety reporting system. Frequencies were analyzed for pre- and post-intervention aggregate data. Results: Findings showed a 53.8% reduction in the unnecessary use of epinephrine for hypersensitivity reactions and a 37% increase in PSRS event reports post intervention. Conclusion: The understanding of grading hypersensitivity reactions and the consequences of administering epinephrine led to the reduction of the unnecessary use of epinephrine. Educating staff on the importance of PSRS events increased the reporting of hypersensitivity reactions.