Congress Abstracts 2005

58

CHAIRSIDE CHECKLIST: AN INNOVATION IN SAFE CHEMOTHERAPY ADMINISTRATION. Sheri Guarino, RN, OCN^®, and Susan Fredericks Hodes, RN, BSN, OCN^®, University of Rochester, James P. Wilmot Cancer Center, Rochester, NY

The Joint Commission on Accreditation of Health Care Organizations (JCAHO) 2004 National Patient Safety Goal to improve the accuracy of patient identification challenges oncology nurses to improve patient care processes. The administration of chemotherapy and biotherapy is a high risk activity requiring multiple safety checks to ensure accurate patient and drug identification and prevent errors.

The purpose of this project is to increase patient safety during chemotherapy administration and reduce the number of chemotherapy related medication errors in a large outpatient cancer treatment center in Western New York. This location serves approximately 70 patients per day and nurses infuse high volumes of chemotherapy. The need for this project arose from a chemotherapy error that resulted from incorrect identification at several points along the prescribing/admixture/administration axis.

A Root Cause Analysis exercise resulted in several necessary improvements in the pre-administration verification process. Using Crew Resource Management principles, the nursing staff developed a standardized checklist which is utilized to check chemotherapy medication against prescription and patient identifiers at the chair side prior to administration to catch potential errors before they reach the patient. This ChairSide Checklist provides the nurses with a consistent method of performing verification, so that it is performed the same way each time by each nurse, minimizing the variation between practitioners and potential for errors. The method of project implementation and utilization will also be described.

Project goals are evaluated on an ongoing basis utilizing the Plan, Do, Study, Act Model. Since the establishment of the ChairSide Checklist, an 80% reduction of event occurrence reports due to identification of patient and/or medication variables has been observed. Nurse satisfaction with the process and patient reaction to the safety measures will also be described.

This topic has wide implications in providing a concrete method of implementing the principles of the JCAHO National Patient Safety Goals. The standardization of patient and drug verification during chemotherapy administration is specific to the practice of Oncology Nursing in all settings where cancer care is provided. Future plans include implementation of the ChairSide Checklist on inpatient oncology units.