Reducing Epinephrine Use and Enhancing Documentation for Chemotherapy Hypersensitivity Reactions.

This article focuses on a quality improvement (QI) project aimed at reducing unnecessary epinephrine use and enhancing documentation of hypersensitivity reactions (HSRs) in patients receiving chemotherapy for thoracic cancer at an ambulatory oncology infusion unit. HSRs, defined by the National Cancer Institute Cancer Therapy Evaluation Program as exaggerated immune responses to drugs, can range from mild to life-threatening anaphylaxis and often require rescue medications like epinephrine, which carries risks and increases healthcare costs. The project implemented an educational intervention and a decision tree tool to guide nurses in accurately grading HSR severity and managing treatment, resulting in a 53.8% reduction in epinephrine administration and a 37% increase in event reporting in the patient safety reporting system. The findings suggest that targeted education and standardized protocols can improve patient safety and care quality by ensuring epinephrine is reserved for appropriate clinical situations and by promoting consistent documentation of HSRs.