Chemotherapy medication errors: descriptions, severity, and contributing factors.

Abstract

PURPOSE/OBJECTIVES: To expand the limited body of knowledge of medication errors involving chemotherapy. DESIGN: Exploratory, descriptive. SAMPLE: 160 (26%) of 620 randomly selected Oncology Nursing Society members employed in direct patient-care positions and 26 nonmembers with chemotherapy administration responsibilities employed in different settings. METHODS: Mailed investigator-developed questionnaire containing 24 demographic and open-ended questions. MAIN RESEARCH VARIABLES: Nurses' descriptions of the nature and severity of chemotherapy medication errors. FINDINGS: Chemotherapy medication errors were reported to have occurred in the workplace of 63% of the respondents, and 140 errors were described. Errors included under- and overdosing, schedule and timing errors, wrong drugs, infusion-rate errors, omission of drugs or hydration, improper preparation of drugs, and chemotherapy given to the wrong patients. Stress, understaffing, lack of experience, and unclear orders were cited as factors believed to contribute to the occurrence of the errors. Most of the errors were reported internally, but only 3% were known to be reported to national reporting databases or drug manufacturers. CONCLUSIONS: Chemotherapy medication errors are not uncommon and infrequently are reported externally to databases or manufacturers. IMPLICATIONS FOR NURSING PRACTICE: Risk management strategies to promote safe chemotherapy administration include comprehensive chemotherapy administration training, adherence to basic principles of medication administration, and adequate staffing. Oncology nurses need to know how and when to report chemotherapy medication errors to national databases and drug manufacturers.