Impact of implementing the aseptic compounding management system, Medcura, on internal error rates within an oncology pharmacy aseptic unit: a mixed methods evaluation

Abstract

Background As cancer survivorship improves, pressure on oncology services to provide safe, timely treatments increases. Traditional manual compounding processes are error prone, putting patients at risk. Additionally, errors have a detrimental impact on service delivery and staff morale. Information technology is increasingly utilised to improve safety and service delivery of systemic anticancer therapy (SACT). The compounding process control system, Medcura, was developed to manage the endto-end process and reduce transcription and calculation errors. Objectives To evaluate the impact of implementing Medcura on internal errors and staff perceptions of errors. Method An aseptic process control system, Medcura, was implemented in a busy pharmacy chemotherapy production unit. Internal error and severity data were collected and analysed for 14 months before and during implementation, and 24 months after implementation. In addition, one-to-one semi-structured interviews were carried out with pharmacy staff, pre-and postimplementation. Interviews were transcribed and thematically analysed. Results Error rates decreased after implementation from 2.9% to 2.1%. The types of error detected also changed with a decrease in worksheet and labelling errors, and an increase in assembly errors. The severity of the errors, as a percentage of total errors made, also decreased after implementation. Staff were predominantly positive about Medcura; it reduced the number of errors, eased the preparation of worksheets and labels, reduced pressure and work-related stress, and improved job satisfaction. Conclusions Implementing Medcura has resulted in a reduction in both error rate and severity. Specifically, errors related to label and worksheet generation have seen the largest reduction. Staff have viewed these changes positively and report reduced levels of workrelated stress. Further development and roll-out will improve patient safety and staff morale. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY⇒ Implementing an aseptic compounding management system such as Medcura can improve patient safety and staff morale.