Implementing a Standardized Hypersensitivity Reaction (HSR) Guideline in Caring for Chemotherapy/Biotherapy Patients

By MAK Wing Kwan, Shirley, RN, BSN, MNurs(Palliative Care), Comprehensive Oncology Center


According to the case review of incident rate of HSR in Comprehensive Oncology Center in HKSH between November and December in 2016, the incident rate is 4%, which is similar as the literature review. In regard to the management of HSR in our hospital, it is according to customary practice as well as lack of information about the precautionary measurement. There are two problems: 1. No evidence-based guideline for HSR management; 2. No updated information to increase nurses’ awareness.


Hypersensitivity Reaction (HSR) during chemotherapy is the immune response which causes patient discomfort during the infusion therapy because of receiving the therapeutic agents. Although the incident rate is rare which is less than 5%, the consequence can be severe,  and even cause death. In addition, the treatment plan would be altered as re-challenged or discontinued. Therefore, there is a great impact when it happens.


A standardized hypersensitivity reaction guideline is implemented in order to enhance nurses’ competence in caring for chemotherapy/biotherapy patients.


Pre- and post questionnaires about knowledge of HSR and the competency of handling HSR cases were sent to 60 nurses with 90% response rate. After the implementation of HSR guideline with launching education program, there was 62.5% improvement regarding the knowledge of HSR. Moreover, the participants are more confident on handling the HSR cases after the implementation of HSR guideline.


There are three recommendation for next steps: 1. Regular revision of guideline in order to update the content; 2. Emergency drug box is suggested to put at the bedside of the high risk cases; 3. Re-challenge guideline should be implemented to understand the following treatment plan after HSR.