Cancer chemotherapy: Potential errors with external referrals

Abstract

Objective: To determine the incidence of potential or actual medication errors in cancer chemotherapy of patients referred from other institutions. Method: The medical records of the last 100 patients referred to the Oncology Unit of Toowoomba Base Hospital, whose treatment was initiated outside the institution, were retrospectively reviewed. Results: Referrals came from 15 different centres and 30 prescribers. Only 28% of records showed no potential for error, the other 72% had possible errors as follows: one error (40%), two errors (22%), three errors (4%) and four errors (6%). The severity of potential errors varied, most had minor significance. The most common faults were: not listing the prescribed dose as a mg/m2 dose to enable dosage verification (54%), handwritten orders (18%), and not designating the length of time between cycles (17%). Four significant errors were detected, three involved mistakes in chemotherapy protocols and the other was a calculation error. Fortunately, these errors were detected by the pharmacist before treatment started. Conclusion: It is vital that information provided between chemotherapy units be accurate, clear, thorough, and leave no potential for misinterpretation. This is particularly important when referring patients to centres without physicians or pharmacists experienced in the use of antineoplastic agents.