Sensorial Disturbances of Prefilled Saline Flushes and Their Impact on Cancer Patients

By 2035, the number of cancer cases will reach 22 million worldwide with many of these cancer patients receiving intravenous chemotherapy (National Cancer Institute, 2016). Normal saline intravenous (IV) flushes are a standard practice in chemotherapy administration procedures. Chemotherapy cancer patients are especially hypersensitive to taste and smell changes. Unfortunately, chemotherapy patients complain of sensorial disturbances including taste and smell changes during the saline IV flush procedure. Kolcaba’s Theory of Comfort conceptually aligned with the study on saline IV flush sensorial disturbances causing patient discomfort. The quasi-experimental study, conducted at an Atlantic Coast cancer institute, explored the effects of prefilled saline syringes compared to non-prefilled saline syringes pre-chemotherapy administration on the chemotherapy patient’s sensorium. The study followed standard policies for IV access and flushing. Adult study participants (N = 30) were randomly grouped according to prefilled saline syringes and non-prefilled saline syringes for the pre-chemotherapy flushes and blinded to the assigned type of IV saline flush administered. Study participant responses describing a sensorial change after receiving prefilled saline flushes included such adjectives as: medicine-like, alcohol, chemical, distasteful, bitter, yucky, and metallic. Study participants who received non-prefilled saline flushes described the sensorial change as sweet or medicine-like. In a scale of 0 to 10 with 0 being no discomfort at all and 10 being the worst imaginable discomfort, a mean discomfort score of 2.5 was reported by those experiencing a sensorial disturbance from prefilled saline flush administration compared to a mean discomfort score of 0 by those experiencing a sensorial disturbance from non-prefilled saline flush administration. A two-tailed t-test analysis concluded a significant p-value of 0.0194 in the number of sensorial disturbances reported between the group receiving prefilled saline syringes pre-chemotherapy compared to the group receiving non-prefilled saline syringes pre-chemotherapy. Study recommendations include a nursing assessment of the adult chemotherapy patient’s past history of sensorial disturbances with prefilled or non-prefilled saline flushes before IV administration to prevent discomfort. Future research recommendations for a randomized clinical control trial of adult chemotherapy patients receiving prefilled and/or non-prefilled saline syringe IV flushes throughout the entire chemotherapy administration procedure is appropriate.

Keywords: prefilled saline, saline flush, sensorial disturbance, chemotherapy, altered taste, odor disturbance, discomfort, Kolcaba’s Theory of Comfort