Prevention System Development of Chemotherapy Medication Errors in Chemotherapeutic Mixing Unit in Rajavithi Hospital

Abstract

Background:  Chemotherapy is a cancer treatment medicine that use in the world, but it may be a medication error incidence in chemotherapy providing process which is harmful to organs and life of patients. However, it can prevent.

Objectives: To develop and evaluate the prevention system of medication error within the chemotherapeutic mixing unit for cancer patients who received all injectable chemotherapeutic agents in Rajavithi hospital.

Methods: The study was a quasi-experimental design by collecting the medication error incidences and severity levels, analyzed the root causes to develop medication error prevention system, and trail. In addition, it evaluated the medication errors by comparing a medication error incidence ratio between before and after implementation of this prevention system.

Results: The results show that the number of 15,388 injectable chemotherapeutic drug preparations was a total medication errors at 3.46% (269 errors from 7,771 drug preparations). It classified the drug ordering processes that most found include: in transcription processes, pre-dispensing processes, dispensing processes, and prescribing processes, respectively. After the use of the medication error prevention system was implemented in the mixing unit, the total medication errors reduced statistically significant (p<0.001) by 2.11% (161 errors from 7,617 drug preparations). The severity levels of medical errors were only A and B level which there was not harms to the patients. Most injectable chemotherapeutic errors were fluorouracil, carboplatin, and paclitaxel.

Conclusions: The developing strategies of medication error prevention systems from evidence-based incidence and severity, root causes analysis and work contexts were able to reduce medication errors and preventable harms to the patients. As a result, the medication error prevention system application in other hospital units would be increase a qualified service standardize for the safety of patients.