Selection of central versus peripheral vascular access in patients receiving chemotherapy: A survey among Italian nurses promoted by the Italian Lymphoma Foundation.

BACKGROUND AND OBJECTIVES: Central venous catheters are recommended for chemotherapy administration, but peripheral intravenous catheters are frequently used. This study examined venous access practices (central vs peripheral) for administering antineoplastic agents to patients with solid or hematologic malignancies and assessed the associated educational aspects.

DESIGN, SETTING, AND PARTICIPANTS: A questionnaire developed according to the Enhancing the Quality and Transparency of Health Research Guidelines was distributed to Italian hematology/oncology nurses who performed intravenous chemotherapy administration and peripheral vein cannulation. Of 171 questionnaires returned, 141 were completed.

RESULTS: Statistics showed that 33% of respondents used peripheral veins for at least 25% of patients within 30-day period. Peripheral veins were chosen because of organizational challenges, urgency, and central catheter issues or malfunctions. Irritant and vesicant drugs were administered by 60% and 49.3% of respondents. The study found 81.7% of nurses received additional education on chemotherapy administration. While 95.8% of nurses informed patients about chemotherapy side effects and extravasation signs, 77.5% did not document this in patients' charts. Informed consent forms often lacked specifications for peripheral vein administration (63.9%), essential for safe antineoplastic agent administration.

CONCLUSIONS: The survey highlighted the need for standardized guidelines for intravenous chemotherapy, as peripheral veins serve multiple purposes.