Congress Abstracts 2003

27

THE CHEMO OLYMPICS: A FUN APPROACH TO SAFETY IN CHEMOTHERAPY PRACTICE. Aiko Kodaira, RN, MS, OCN^®, Johns Hopkins Hospital, Baltimore, MD.

Patient safety is the major focus in our NCI-designated comprehensive cancer center. We have instituted safety measures such as a chemotherapy checklist and pre-printed standing chemotherapy order sets along with a revised chemotherapy orders by nurses, which resulted in more frequent phone calls to physicians for order clarifications to meet the protocol requirements. At times, this caused friction between nurses and physicians with nurses often feeling like the “Chemo Police.”

Coinciding with the 2002 Winter Olympics, one of our physicians suggested holding a “chemo olympics.” We believed that by making a contest out of chemotherapy protocol, their practice would be improved. Nurses anticipated that this would increase patient safety and decrease the time required to clarify and correct orders. The clinical nurse specialist (CNS) designed a scoreboard with the rules attached. The rules were simple. Physicians were awarded points for perfectly written chemotherapy orders. Each time a physician wrote a chemotherapy order, the CNS evaluated it and awarded points. If orders needed clarification, points were taken away. To make the game even more fun, the nurse manager could award 10 “special points” for outstanding chemo-related jobs. Friendly competition developed with the physicians making sure their orders were correct in order to receive the earned points. The race for the highest score was neck-and-neck, so some friendly bribes, such as bringing bagels for the staff, earned them extra points. The olympics increased awareness of the prescribing requirements of the chemotherapy protocol and promoted a sense of teamwork. The number of phone calls for clarification decreased as the clarity of chemotherapy orders increased. The nurses felt less pressure to be the “chemo police.” Subsequently, the “chemo world cup” was held. The “chemo world series” and “chemo super bowl” are upcoming events planned in the spirit of friendly sporting competition to improve chemotherapy safety.