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

Abstract

Objective: to identify and synthesize the scientific evidence on cancer patient safety in the administration of antineoplastic and immunotherapeutic chemotherapeutic agents. Method: a scoping review, according to the Joanna Briggs Institute and to the recommendations of the PRISMA-ScR international guide. The research was conducted in five electronic databases, the Cochrane Library and eight catalogs of theses and dissertations. The inclusion criteria were the following: studies related to patient safety in the administration of antineoplastic and immunotherapeutic chemotherapy by nurses in places where cancer care occurs, published entirely in Portuguese, Spanish and/or English, with no time limit. The extracted data were analyzed and synthesized in narrative form. Results: a total of 14,444 records were retrieved and 47 studies were kept for review. Most publications (44.7%) had a qualitative approach, while 40.4% were quantitative and 14.9%, mixed. When summarizing the findings, the following themes emerged: Safety standards in parenteral administration of antineoplastic chemotherapy; Good practices for patient safety using oral antineoplastic therapy; Administration and safe handling of immunotherapies; Prevention and management of errors related to the administration of antineoplastic and immunotherapeutic chemotherapeutic agents. Conclusion: patients safety with cancer in the administration of antineoplastic therapy occurs when there is implementation of evidence-based protocols, continuing education of nurses and implementation of safety standards and processes, as a strategy to prevent errors in drug administration.

Knowledge about antineoplastic drugs: implications for the health of nursing workers in a general hospital

“…However, some professionals revealed that they obtained their knowledge through alternative means and without scientific basis. Knowledge about antineoplastic drugs and their adverse health effects, acquired systematically and based on theories and evidence, is extremely important to increase the adherence of workers to safety and protection measures (10,14) .…”

“…For the use of antineoplastic drugs in the treatment of cancer and other pathologies to occur safely, it is necessary that professionals have theoretical knowledge and technical skills and that a substantial safety culture is developed so that they understand the process of occupational safety necessary for the handling of these drugs. Without this prior knowledge of risk, it is more difficult to prevent harm (10) .…”

“…keeping the recommendations updated and training professionals about antineoplastic drugs, it is expected that health professionals, especially those on the nursing staff, will be less vulnerable. Considering this situation, in order for workers' exposure to antineoplastic drugs to be minimized, investments in permanent education and standardization of routines for all processes involving the handling of antineoplastic drugs are necessary (10) .…”

“…The care for patients who use antineoplastic drugs is not restricted to the reference institutions for cancer treatment (8)(9) and is being carried out at all levels of health care by trained or untrained professionals (10) . Based on the professional practice, it was observed that patients referred to the general hospital, the setting of this study, for treatment of clinical situations such as diabetes, heart, kidney, rheumatologic pathologies, among others, often have associated with their clinical picture stories of cancer or autoimmune diseases, which require the use of antineoplastic drugs.…”

“…Added to the gap in scientific production about the knowledge about antineoplastic drugs of nursing professionals from general hospitals, there is also the lack of acquisition of "patient and professional safety awareness" (10) through continuing education supported this research. When discussing safety culture, which involves a set of shared beliefs that support safe practices, it is worth noting that it is a primordial strategy for ensuring quality care, by training professionals, making safety equipment available, establishing protocols and notification flows, and organizational measures (12) .…”