[Incident surveillance in outpatients treated with hepatic arterial infusion (HAI) chemotherapy with infusion pump]

An incident situation of hepatic arterial infusion (HAI) chemotherapy was investigated, and the improvement methods were evaluated.As a result of surveillance, all incidents were observed in patients during five day continuous HAI infusion conditions: 1) Reverse-flow hemorrhage occurred at home by disconnection of the catheter; and 2) hemorrhage by natural withdrawal of the huber needle, were diagnosed. For 1) we further taped the catheter connection area by Tegaderm and changed the dressing material from SILKYPORE DRESSING (10 x 13 cm and 4 x 6.5 cm in absorption part) plus two-person fixation by Fixomull stretch to IV3000 (9 x 12 cm non-absorption part) plus three-person fixation by Fixomull stretch. Moreover, we changed the needle type (subcutaneous adiposus thickness) from 22 G x 3/4 inch to 20 G x 1 inch.The incidents were not observed in 72 patients treated with HAI after improvement. We suggest that prevention of hemorrhage by further taping the catheter connection and improved stability of the needle by dressing proved effective. In conclusion, HAI incident surveillance may well be an important way to care for outpatients treated with HAI chemotherapy, and we thus intend to continue the HAI incident surveillance to improve the nursing care.