Clinical audit to assess delays in chemotherapy administration at daycare oncology center at a tertiary care hospital in Karachi, Pakistan

Aziz, Ayesha; Samoon, Zarka; Khurshid, Mohammad; Feroz, Afsheen; Ayoub, Nadia; Awan, Safia; Beg, M. H.

doi:10.4103/ijc.ijc_493_17

Cited by 2 publications

(6 citation statements)

References 11 publications

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“…Thirty drugs were involved in the pharmaceutical interventions, Carboplatin and Ondansetron being the most frequent. 4 In the current study, medication errors were more frequently found with Etoposide and Cisplatin for indent (order) of wrong strength of the drug followed by wrong dose transcribing of Etoposide and Transtuzumab.…”

Section: Discussionmentioning

confidence: 49%

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Medication errors in an oncology inpatient setting in India—Audit by clinical pharmacists

Chaudhari¹,

Mule²,

Dhande

2022

J Oncol Pharm Pract

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Background Good clinical practices and strict vigilance are needed, especially for patients receiving chemotherapy. Regular audits using a specially developed tool need to be conducted in the oncology wards to identify lapses in the use of chemotherapy drugs. Methodology Observational study was conducted in the adult and paediatric oncology inpatient settings in an Indian tertiary care hospital for a period of 2.5 years. It was an audit of case files of chemotherapy patients for their drug prescriptions, medication reconciliation records and adverse drug reports. Data was presented as frequencies and percentages. Results 1.3% medication errors and 0.23% adverse drug reactions were reported during the study period. Majority were transcription (38%) and drug reconstitution errors (29%) and were either in the near-miss or no-harm category. Conclusion Medication errors were found in the oncology wards, but due to the vigilance of clinical pharmacists, none of the patients were harmed as a consequence of these errors.

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Section: Discussionmentioning

confidence: 49%

“…Studies found during literature search have mainly focussed on adverse drug reactions 3 or audit for delays in drug administration of these chemotherapy medications. 4…”

Section: Introductionmentioning

confidence: 99%

Medication errors in an oncology inpatient setting in India—Audit by clinical pharmacists

Chaudhari¹,

Mule²,

Dhande

2022

J Oncol Pharm Pract

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“…Reducing chemotherapy delays have been shown to have positive outcomes for both the patients and institution. [3][4][5][6] While we were successful in reducing the number of chemotherapy delays based on our institutional benchmark (7.0%) and non-compliance rates (15.0%), we did not achieve our goal of a 30% reduction. However, we achieved all our secondary outcome goals, a 10.0% reduction, except for our preparation time which only saw a 3.9% reduction.…”

Section: Discussionmentioning

confidence: 80%

“…Previous studies have shown that causes of chemotherapy delay are multi-factorial. [1][2][3][4][5][6][7][8][9][10] One major reason for our delays was due to an inconsistent timing on order release (defined as orders released at any time of the day) relative to when the chemotherapy is scheduled for administration. If an order is released early with a late scheduled administration time, the order may sit in the verification queue, preparation process, or central pharmacy for a long time causing an extended wait time for our patients.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Previous studies have assessed chemotherapy delays from hospital admission to administration, we took a pharmacy focused approach to evaluate the causes of chemotherapy delays and implemented new methods to reduce delays from order release to chemotherapy administration on an inpatient oncology unit at Lyndon B. Johnson (LBJ) hospital. [3][4][5][6]…”

Section: Introductionmentioning

confidence: 99%

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Reducing chemotherapy administration time on an inpatient oncology unit

Nguyen

Ononogbu

Egwim

et al. 2020

J Oncol Pharm Pract

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Purpose Due to the multifaceted chemotherapy workflow within the hospital, many patients often experience delays in receiving their treatment. This study aims to evaluate the causes for chemotherapy administration delays and implement new methods to reduce delays from order release to chemotherapy administration on an inpatient oncology unit at a community-focused academic medical center. Methods In this prospective quality improvement study, we developed a process map to track baseline time stamps and utilized performance improvement tools to identify causes for chemotherapy delays. Based on recognized areas for improvement, the Plan-Do-Study-Act (PDSA) model was used to implement one cycle of interventions. Chemotherapy orders were collected, and benchmark time stamps were documented from the electronic medical record. Results The primary outcome for the number of chemotherapy delays, based on compliance rate, was reduced from 63/100 (63.0%) to 48/100 (48.0%), a 15% reduction (p = 0.046). Our primary outcome of chemotherapy delays, based on our institutional benchmark of <3 hours, did not show statistical significance. Median time from chemotherapy order release to administration decreased from 7.08 hours at baseline to 6.10 hours post-intervention, a 13.8% reduction (p < 0.0001). Median verification, preparation, and delivery times were all reduced post-intervention by 13.0% (p < 0.0001), 3.9% (p = 0.024), and 14.8% (p < 0.0001) respectively. Conclusions This study allowed our institution to evaluate our current practice and reformulate the chemotherapy administration process. With the continuing education on the chemotherapy administration process and additional PDSA cycle interventions, it will help standardize our process and ultimately continue to reduce chemotherapy delays.

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Clinical audit to assess delays in chemotherapy administration at daycare oncology center at a tertiary care hospital in Karachi, Pakistan

Abstract: After separating initial assessment process into two different areas, delays in chemotherapy administration were reduced.

Cited by 2 publications

References 11 publications

Medication errors in an oncology inpatient setting in India—Audit by clinical pharmacists

Medication errors in an oncology inpatient setting in India—Audit by clinical pharmacists

Reducing chemotherapy administration time on an inpatient oncology unit

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