Errors Common in Outpatient Cancer Treatment

Researchers analysed data on nearly 1,300 patient visits at three adult oncology outpatient clinics and 117 visits at one paediatric facility between September 1, 2005 and May 31, 2006.

Of the seven percent of medication errors involving adults, 55 had the potential to harm the patient and eleven did cause harm. The errors included administration of incorrect medication doses due to confusion over conflicting orders – one written at the time of diagnosis and the other on the day of administration. Some consequences of errors included patients being over-hydrated prior to administration of chemotherapy and complaints of abdominal pain in patients taking narcotics without treatment for constipation. More than 50 percent of errors involving adults were in clinic administration, 28 percent in ordering of medications, and seven percent in use of the drugs in patients’ homes.

About 40 percent of the 22 medication errors in children had the potential to cause harm and four children were harmed. Examples of paediatric errors included giving the wrong amount or the wrong number of times a day for home medicines because of confusion about instructions. In children more than 70 percent of the errors in children occurred at home.

According to the study’s leader, Kathleen E. Walsh, avoiding prewriting of chemotherapy orders in adults in outpatient clinics may have prevented many of the errors in the adults, whereas most of those involving children could have been avoided by better communication, training, and support for parents of children who use chemotherapy medications at home.; Source: Agency for Healthcare Research and Quality (AHRQ)