113P Chemotherapy administration safety standards for preventing medication errors and adverse drug reactions in patients with breast cancers

Abstract

Background: The high toxicity and low therapeutic index of antineoplastic drugs make medication errors a notable problem which can culminate in excessive patient morbidity and cost. To boost the quality of care provided in medicine, it is essential to implement a system that reduces the number of chemotherapy errors. In the current study, the authors aimed to evaluate effect of implementation of standard form and detect medication error and adverse drug event (ADE) rates involving cytotoxic drugs used in breast cancer regimen in the outpatient chemotherapy setting. Methods: A cross sectional-interventional study was performed prospectively in two adult outpatient centers. To avoid errors, a standardized order sheet was established to document information regarding breast cancer chemotherapy. Effect of standard sheet on lessening errors in ordering and administration was evaluated. The epidemiology of Errors and Adverse drug events were reported. Results: Of 217 adult patient visits (164 visits in public hospital and 70 visits in private clinic) from 84 patients (64 in hospital and 20 in clinic) involving 385 medications, 41% were associated with a medication error. Of these errors, 5% occurring in private clinic compared with 95% of errors occurring in public hospital. A standardized approach helped to reduce errors in selection of regimen type However, physicians did not calculate doses on the basis of standard sheets so the most common error types were improper dose (38.2% of 89 cited error types). Effect of standard sheets in administering phase could not assess due to incomplete entering data by nurses. Sixty-two percent of errors originated in the prescribing phase of medication delivery, and 33% originated in the administering phase. ADE rate was 9.6% but no life-threatening adverse drug event was recorded. Conclusions: In the current study, authors found that standardized order sheets would be very beneficial and minimize medication errors if they are used accurately. Also this study provided important information about the rate and epidemiology of medication errors.