Medication Errors in Chemotherapy Preparation and Administration: a Survey Conducted among Oncology Nurses in Turkey

Abstract

Background: Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. Materials and Methods: This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Results: Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Conclusions: Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures and establishing multistep control mechanisms.

Effect of unintentional cyclophosphamide underdosing on diffuse large B-cell lymphoma response to chemotherapy: a retrospective review

“…6 Such errors are not an uncommon problem in cancer centres, with reports showing 7000 patients deaths and 80 000 admissions to hospital annually in the United States, 7 with similar results reported in Canada. 8 Errors may occur at any stage of the treatment process, from prescribing to administration.…”

Patient Safety in the Administration of Antineoplastic Chemotherapy and of Immunotherapics for Oncological Treatment: Scoping Review

“…The other studies were published in different health journals. 3,[13][14][15][16]19,21,[24][25]31,33,43,[36][37]39,42,47,[49][50] The safety of cancer drug administration in adults, children and young people in hospitals, [3][4][6][7][13][14][15][16][17][18][19][20][21][22]27,33,[35][36][40][41]44,[47][48][49][50]52 outpatient clinics, [3][4][5][16][17][18][19...…”

“…[4][5][6][7]13,[19][20]22,[24][25][27][28][29][30][33][34]36,44,47,[49][50][51][52][53] Diverse studies stood out that signaled as essential the use of tools for managing risks related to drugs, such as the HFMEA (Healthcare Failure Mode and Effect Analysis) and Lean Sigma, methodologies used to map, evaluate and propose the control of incidents before they occur and to detect hidden incidents in the system, error reporting and surveillance systems; a checklist of items for safe administration of antineoplastic drugs. 22,25,28,30,37,42,44…”

Expected Prescription Error (EPE) Scores of Cancer Drugs in Egypt: A New Method of Data Extraction from a Questionnaire Based Study

“…Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1times/month, range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%).…”