In one of the first studies to examine chemotherapy errors in ambulatory care for cancer patients, researchers at Dana-Farber Cancer Institute (DFCI) and Brigham and Women's Hospital (BWH) have found that about three percent of chemotherapy orders in three outpatient infusion clinics studied contained mistakes.
Most of the errors were intercepted by nurses and pharmacists before reaching patients, and none were life-threatening or caused patient harm; but the results show that room for improvement exists even in hospitals with strong error-prevention programs, the authors say.
The research, reported in today's online version of the journal Cancer, was made possible by Dana-Farber and BWH leaders' decision to share drug-order and patient-safety records with investigators. Both hospitals are established leaders in efforts to reduce medication errors and heighten patient safety. The findings of the study have prompted both Dana-Farber and Brigham and Women's to make changes in the hospital's automated drug order-entry system to further lessen the chance of mistakes.
"Our results show that while safeguards such as computerized order-entry systems - used at both Dana-Farber and Brigham and Women's - significantly reduce drug-order errors, additional improvements are still possible, and necessary" says the study's co-lead author, Tejal Gandhi, MD, MPH, of Brigham and Women's.
Adds co-lead author Sylvia Bartel, RPh, MHP, of Dana-Farber, "DFCI's leadership supported the in-depth review of all medication orders to gain information about potential system defects. The goal was to utilize the results of the study to make system improvements and ensure a safe medication process for our patients."
Previous studies have estimated that about five percent of drug orders for hospitalized patients have errors, but much less scientific attention has been given to the prevalence of such mistakes in outpatient settings. While medication errors often don't harm patients, the complexity of some chemotherapy regimens, and the toxicity of the drugs, makes it particularly important to minimize mistakes in ordering and administering cancer therapies.