Desenvolvimento de um plano de curso de capacitação de apoio à educação permanente sobre cuidados de enfermagem na prevenção e manejo do extravasamento de quimioterápicos

Abstract

Cancer is a chronic disease, evidenced as a strong indicator of global morbidity and mortality. In Brazil, it represents the second leading cause of death, constituting a public health problem. Among the possible treatments, chemotherapy stands out because it increases patient survival, but due to its high toxicity, it can cause the extravasation of antineoplastic agents, constituting an adverse event. Because of this, the administration of chemotherapy requires care that guarantees quality, safe and comfortable health care, avoiding pain or other undesirable reactions. This study aims to develop a training course plan to support continuing education on nursing care in the prevention of chemotherapy extravasation in cancer patients. Methodological study, carried out in three stages proposed by Filatro: in the first, mapping of nursing care for the prevention and management of chemotherapy extravasation in cancer patients, through a scoping review; In this stage, a field study was also carried out on the learning style of nursing professionals in two oncology hospitals in the city of Natal, capital of Rio Grande do Norte; in the second stage, the course plan was structured into four modules with the description of the contents, learning objectives, teaching resources and methodology, based on David Kolb's learning framework, in addition to Betty Neuman's theoretical nursing framework; in the third stage, the validation of the course content was implemented, with five expert judges through the application of the average of the Content Validation Index together with the Kappa Coefficient and the Delphi technique to reach consensus among them. The research was approved by the Research Ethics Committee of the Potiguar University and the Research Ethics Committee of the League Against Cancer, complying with the ethical precepts of Resolution No. 466/12, of the National Health Council. The results of the scoping review mapped nursing care for prevention and management of extravasation, categorized according to the levels of prevention of Betty Neuman's Systems Theory. The findings of the field research identified that, regarding the professionals interviewed, the majority were female (85.71%), up to 35 years of age (53.38%), married (47.73%), mixed race (60.15%) and Catholic (59.40%); regarding the level of education and time of experience, the majority (73.68%) had technical or high school education, with time of experience of up to 05 years in the service (62.99%); regarding knowledge about oncology, the majority (84.96%) reported having partial knowledge about chemotherapy, and only (2.26%) stated that they had sufficient knowledge; Knowledge about the routes of administration of chemotherapy drugs is also below expectations (32.33%), even though 61.65% of them know about the severe damage caused by vesicant chemotherapy drugs in the case of extravasation; while 44.36% knew how to differentiate vesicants from irritants, another 64.66% distinguished extravasation from infiltration; regarding nursing care, the majority (84.96%) identified preventive measures for extravasation and (79.70%) stated they knew how to implement them; however, only some of them (39.10%) know the existing protocols; however, the vast majority (93.98%) evaluate the venous network before infusing chemotherapy drugs. Other results showed significant differences between the functions of professionals and knowledge about vesicant and irritant chemotherapy drugs, as well as between extravasation and infiltration. Nurses demonstrated greater general knowledge, except in relation to extravasation protocols, in which technicians stood out. Regarding the results of the validation stage of the course by the judges, overall indices of 0.97 were achieved for clarity, 0.99 for relevance, and 1.00 for pertinence, consistency, and objectivity, reflecting high reliability of the instrument through a single Delphi round. It is concluded that the course plan was validated with high reliability, evidenced by the adequacy and precision of the proposed criteria. It is expected that the proposed course plan will contribute to the training of nurses and nursing technicians, with an emphasis on the prevention and management of extravasation of antineoplastic agents, which may result in safer, more effective comprehensive care and consequent reduction of harm and adverse effects for patients undergoing cancer treatment.