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Medication Errors in Chemotherapy Preparation and Administration: a Survey Conducted among Oncology Nurses in Turkey

  • Ulas, Arife (Department of Medical Oncology, Ankara Ataturk Training and Research Hospital) ;
  • Silay, Kamile (Department of Internal Medicine and Geriatrics, Yildirim Beyazit University, Ataturk Research and Training Hospital) ;
  • Akinci, Sema (Department of Hematology, Ankara Ataturk Training and Research Hospital) ;
  • Dede, Didem Sener (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University, Ataturk Research and Training Hospital) ;
  • Akinci, Muhammed Bulent (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University, Ataturk Research and Training Hospital) ;
  • Sendur, Mehmet Ali Nahit (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University, Ataturk Research and Training Hospital) ;
  • Cubukcu, Erdem (Department of Medical Oncology, Ali Osman Sonmez Oncology Hospital) ;
  • Coskun, Hasan Senol (Department of Medical Oncology, Faculty of Medicine, Akdeniz University) ;
  • Degirmenci, Mustafa (Department of Medical Oncology, Izmir Tepecik Training and Research Hospital) ;
  • Utkan, Gungor (Department of Medical Oncology, Ankara University School of Medicine) ;
  • Ozdemir, Nuriye (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University, Ataturk Research and Training Hospital) ;
  • Isikdogan, Abdurrahman (Department of Medical Oncology, Faculty of Medicine, Dicle University) ;
  • Buyukcelik, Abdullah (Department of Medical Oncology, Acıbadem University School of Medicine) ;
  • Inanc, Mevlude (Department of Medical Oncology, Kayseri Education and Research Hospital) ;
  • Bilici, Ahmet (Department of Medical Oncology, Faculty of Medicine, Istanbul Medipol University) ;
  • Odabasi, Hatice (Department of Medical Oncology, Lutfi Kirdar Kartal Education and Research Hospital) ;
  • Cihan, Sener (Department of Medical Oncology, Istanbul Okmeydanı Training and Research Hospital) ;
  • Avci, Nilufer (Department of Medical Oncology, Balıkesir Government Hospital) ;
  • Yalcin, Bulent (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University, Ataturk Research and Training Hospital)
  • Published : 2015.03.18

Abstract

Background: Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. Materials and Methods: This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Results: Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Conclusions: Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures and establishing multistep control mechanisms.

Keywords

Medication errors;chemotherapy;nursing;chemotherapeutic drug preparation/administration

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