Intravenous chemotherapy preparation errors: Patient safety risks identified in a pan-Canadian exploratory study

Abstract

Dispensing errors in high-risk intravenous preparation have been studied in the past, but it is unlikely that these studies have detected these errors because of the inherent limitations of the detection methods used. Research on preparation errors using more sensitive methods is therefore urgently needed to establish the extent to which pharmacy preparation practices may be error-prone, and to allow reliable evaluation of the impact of mitigation strategies. Widespread practice changes in Canadian oncology pharmacies are necessary, and are currently underway.

Implementing a clinical pharmacy service in hematology

“…White et al reported that higher rates of errors with antineoplastic medications were found in outpatients, which is consistent with our results. (20) …”

2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology

“…1.14 The health care setting has policy for reporting of adverse events and near misses and has a formal process for collecting and evaluating data at a defined frequency. 11,13,25,26 Domain 2: Treatment Planning, Patient Consent, and Education…”

“…Similarly, during batch preparation, labels can be incorrectly applied to containers of prepared doses. 13 This update of the ASCO/ONS Chemotherapy Administration Standards began with a formal systematic literature review. For the first time, the standards were expanded to specifically address chemotherapy safety for pediatric patients.…”

SIMMEON-Prep study: SIMulation of Medication Errors in ONcology: prevention of antineoplastic preparation errors

“…The SIMMEON‐Prep program described here is a novel simulation‐based learning tool to prevent ME in the preparation of anticancer drugs in hospital. The preparation stage is known to be prone to errors, and preparation errors are not systematically detected at the only further stage, that is administration.…”

“…Nevertheless, pharmaceutical errors still occur and are under‐documented. Several potential errors may occur during the preparation of antineoplastic agents . The preparation error rate ranges from 0∙23% to 6∙66%, depending on the study and the error detection method used.…”