| Sumario: | Significance & Background: Ambulatory infusion pumps play a vital role in oncology nursing, especially for administering 5-Fluorouracil (5-FU), which requires continuous infusion over 24 to 48 hours. While these pumps allow patients to receive treatment at home, they present safety risks if not managed correctly. Common issues include improper connection, pump malfunction, needle dislodgement, and lack of scheduled follow-up for pump disconnection, potentially leading to serious adverse events. Ensuring proper pump setup, confirming connection integrity, and providing thorough patient or caregiver education before discharge are essential to support safe, effective ambulatory pump chemotherapy. Purpose: At the oncology center, adverse events related to ambulatory chemotherapy pumps, such as closed clamps, accidental disconnections at home, chemotherapy spills at home, and needle dislodgement, have been reported. This quality improvement project aims to reduce such incidents by identifying contributing factors and implementing targeted interventions. A key intervention was the development of an electronic connection and disconnection checklist for 5-Fluorouracil ambulatory pump, a patient-centred approach to enhance safety by standardizing nursing practice. Interventions: A multidisciplinary team including frontline nurses, the Day Care Unit Nurse Manager, Clinical Nurse Specialist, and Nurse Educator collaborated to develop an electronic connection and disconnection checklist for 5-FU ambulatory infusion pumps. Integrated into the patient's electronic health record, the checklist standardized nursing practice, reduced human error, and enhanced patient safety. It required dual verification by two chemotherapy-competent nurses. To support implementation, the Education and Practice Council provided in-service training, enabling oncology nurses to use the checklist effectively. Results: To evaluate the project outcomes, the team compared incident data from the pre- and post-intervention periods. During the pre-intervention phase (January 2022-December 2024), eight incidents were reported, which include two involving missed clamp openings (resulting in no dose delivery), two due to accidental needle dislodgement from Port-a-Cath, and four related to missed appointments for pump removal after 48 hours. Following the implementation of the electronic checklist (January 2025-present), no incidents were reported. From January to July 2025, 731 connection and 440 disconnection checklists were completed. Discussion: The integration of technology into nursing care builds safety systems that improve outcomes and strengthen nursing practice. The successful implementation of the electronic checklist resulted in zero reported incidents post-intervention, demonstrating improved adherence to the safety checklist. This directly enhanced patient safety and reduced adverse events related to the ambulatory chemotherapy pump.
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