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

Background: Medication errors in oncology may cause severe clinical problems due to low therapeuticindices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errorsand underlying factors during chemotherapy preparation and administration based on a systematic surveyconducted to reflect oncology nurses experience. Materials and
Methods: This study was conducted in 18 adultchemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators andmedication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparationor administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapyunits; errors and their estimated monthly number during chemotherapy preparation and administration; andevaluation of the possible factors responsible from ME. The survey was conducted by face to face interviewand data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for acomparative analysis of categorical data.
Results: Some 83.4% of the 210 nurses reported one or more than oneerror 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 themost common errors. The most common estimated average monthly error was not following the administrationsequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasonsfor 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 preparationand administration, the most common involving prescribing and ordering errors. Further studies must addressthe strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protectivemeasures and establishing multistep control mechanisms.