Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs

Ranchon, Florence; Salles, Gilles; Späth, Hans-Martin; Schwiertz, Vérane; Vantard, Nicolas; Parat, S.; Broussais, Florence; You, Benoît; Tartas, Sophie; Souquet, Pierre-Jean; Deroanne, Claude; Falandry, Claire; Hénin, Émilie; Freyer, Gilles; Rioufol, Catherine

doi:10.1186/1471-2407-11-478

Cited by 96 publications

(155 citation statements)

References 30 publications

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“…Based on our previous results [21,23], selected events included recent, frequent and severe errors (i.e. errors that contributed to patient damage) or near-miss errors (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…Most studies of medication errors in cancer care report high rates of severe events [18,19,20]. In a previous study, we found that approximately 5% of anti-neoplastic prescriptions contained at least one medication error [21]. Moreover, errors involving anti-neoplastic agents are recognised as the second most common cause of death related to medication errors [22].…”

Section: Introductionmentioning

confidence: 99%

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Improving Cancer Patient Care with Combined Medication Error Reviews and Morbidity and Mortality Conferences

Ranchon¹,

You²,

Salles³

et al. 2013

Chemotherapy

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Background: To reduce the occurrence of medication errors, a systemic approach was developed combining anti-neoplastic medication error reviews and morbidity and mortality conferences (M&MCs). We report the first experience of implementing this strategy in oncology. Methods: The case reports submitted to combined reviews were prepared by physicians and pharmacists, and medication error(s) were described and chronological and root-cause analyses were performed. Results: Ten combined reviews were conducted, which involved the departments of haematology, medical oncology, pneumology, gastroenterology and clinical oncology pharmacy. A total of 91 errors were analysed, of which 3 had reached the patient. Thirty-four corrective actions were proposed; 53% consisted of changes in practice, 35% in procedural reminders and 12% in on-ward education sessions. Conclusions: The combination of medication error reviews and M&MCs appears to be an efficient means of improving cancer patient safety and personnel proficiency. This multidisciplinary work is indispensable to improve future patient management through the critical analysis of past medical errors.

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“…Based on our previous results [21,23], selected events included recent, frequent and severe errors (i.e. errors that contributed to patient damage) or near-miss errors (i.e.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving Cancer Patient Care with Combined Medication Error Reviews and Morbidity and Mortality Conferences

Ranchon¹,

You²,

Salles³

et al. 2013

Chemotherapy

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“…Intravenous antineoplastic agents present additional safety challenges. [1][2][3][4] In addition to patient safety concerns, antineoplastic preparation and administration create significant staff risks. [5][6][7][8][9] The medication use system includes several stages that are vulnerable to opportunities for potentially harmful medication errors (MEs), such as incorrect drug, dose, concentration, or storage.…”

Section: Introductionmentioning

confidence: 99%

Impact of Robotic Antineoplastic Preparation on Safety, Workflow, and Costs

Seger

Churchill

Keohane

et al. 2012

JOP

103

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Purpose: Antineoplastic preparation presents unique safety concerns and consumes significant pharmacy staff time and costs. Robotic antineoplastic and adjuvant medication compounding may provide incremental safety and efficiency advantages compared with standard pharmacy practices. Methods:We conducted a direct observation trial in an academic medical center pharmacy to compare the effects of usual/ manual antineoplastic and adjuvant drug preparation (baseline period) with robotic preparation (intervention period). The primary outcomes were serious medication errors and staff safety events with the potential for harm of patients and staff, respectively. Secondary outcomes included medication accuracy determined by gravimetric techniques, medication preparation time, and the costs of both ancillary materials used during drug preparation and personnel time.Results: Among 1,421 and 972 observed medication preparations, we found nine (0.7%) and seven (0.7%) serious medication errors (P ϭ .8) and 73 (5.1%) and 28 (2.9%) staff safety events (P ϭ .007) in the baseline and intervention periods, respectively. Drugs failed accuracy measurements in 12.5% (23 of 184) and 0.9% (one of 110) of preparations in the baseline and intervention periods, respectively (P Ͻ .001). Mean drug preparation time increased by 47% when using the robot (P ϭ .009). Labor costs were similar in both study periods, although the ancillary material costs decreased by 56% in the intervention period (P Ͻ .001). Conclusion:Although robotically prepared antineoplastic and adjuvant medications did not reduce serious medication errors, both staff safety and accuracy of medication preparation were improved significantly. Future studies are necessary to address the overall cost effectiveness of these robotic implementations.

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“…Eine Datenanalyse einer französischen Universitätsklinik zeigte, dass es bei insgesamt 6607 Verordnungen für stationäre Krebspatienten im Laufe eines Jahres in 341 Fällen (5,2%) zu mindestens einem Medikationsfehler gekommen war; insgesamt waren das 449 Fehler. Nur 436 davon wurden erkannt[2]. Eine weitere Analyse der erkannten Medikationsfehler durch unabhängige Ärzte ergab, dass es bei Nichterkennung in 2,6% der Fälle zu dauerhaften Schädigungen und in 1,8% zum Tod der Patienten gekommen wäre.…”

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Schlaglichter vom 30. Deutschen Krebskongress

Junker¹

2012

Onkologe

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Zum 2. Mal seit der Einführung des größ-ten europäischen Mammographiescreening-Programms im Jahr 2005 legt die Kooperationsgemeinschaft Mammographie die Auswertungen der Daten für Deutschland in einem Evaluationsbericht vor [1]. Erneut wurden die Vorgaben der Europäischen Leitlinien hinsichtlich der Leistungsparameter erfüllt. Die erwartete Entwicklung hin zu einer höheren Entdeckungsrate von kleineren Tumoren und Karzinomen ohne Lymphknotenbefall bestätigte sich. Seit Ende 2009 wird das Programm flächendeckend von 94 Screeningeinheiten angeboten. Jede Frau in Deutschland zwischen 50 und 69 Jahren hat alle zwei Jahre Anspruch auf eine Mammographieuntersuchung. Bei 8 von 1000 Frauen wurde in der Erstrunde Brustkrebs entdeckt. Die Entdeckungsrate sank in der Folgerunde auch im deutschen Programm auf 5 bis 6 von 1000 Frauen.

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Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs

Cited by 96 publications

References 30 publications

Improving Cancer Patient Care with Combined Medication Error Reviews and Morbidity and Mortality Conferences

Improving Cancer Patient Care with Combined Medication Error Reviews and Morbidity and Mortality Conferences

Impact of Robotic Antineoplastic Preparation on Safety, Workflow, and Costs

Schlaglichter vom 30. Deutschen Krebskongress

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