Congress Abstracts 2003

24

IMPROVING CHEMOTHERAPY SAFETY IN A MULTISPECIALTY TERTIARY REFERRAL CENTER. Diana Karius, RN, MS, AOCN^®, Cleveland Clinic Foundation, Cleveland, OH.

Chemotherapy safety has become an increasingly targeted issue in health centers focusing on the prevention of medication errors.

Multi-specialty tertiary referral centers have many issues in the area of chemotherapy safety. These include both physician and nursing education issues as well as environmental and pharmacy issues. Because tertiary referral centers are both multi-specialty and teaching hospitals with high staff turnover, the potential for chemotherapy errors is even greater. The purpose of this performance improvement project was to identify current practice issues and develop strategies to improve chemotherapy safety on both the medical oncology and bone marrow transplant unit at this center. Preliminary safety issues identified included chemotherapy being a high risk, high volume activity on both units, no clear chemotherapy competency process for nursing, no formal process in place for chemotherapy administration by nursing, and incomplete or unclear orders from physicians.

Interventions: A multidisciplinary chemotherapy safety committee including physicians, pharmacists, and nurses was established. A chemotherapy criterion checklist was devised and included in the chemotherapy administration policy. The chemotherapy documentation note was revised to include required elements of the criterion checklist. A pre-printed chemotherapy order sheet was designed.

Results: The interventions were implemented for one month on both units. At the end of the month, 20 charts were reviewed per unit. Modifications were made to the documents and the nurses were re-educated after the first data set. Two separate data sets were obtained tracking nine identified key elements to determine the percent of compliance with the new process. This poster will present six months of data since the initial implementation of the process changes.

Implications for nursing: The data supports that the changes increased compliance in the administration and documentation process for chemotherapy administration. Standardizing the process has, in turn, increased the safety of the nurses administering chemotherapy and the patients they treat.