Utilization of Error Analysis Data in Chemotherapy Order Preparation for Development of a Comprehensive Electronic Chemotherapy Plan of Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/164805
Category:
Abstract
Type:
Presentation
Title:
Utilization of Error Analysis Data in Chemotherapy Order Preparation for Development of a Comprehensive Electronic Chemotherapy Plan of Care
Author(s):
Shearburn, Patricia; Kratz, Melissa
Author Details:
Patricia Shearburn, RN, MSN, AOCN, Oncology Clinical Nurse Specialist, Lehigh Valley Hospital, Allentown, Pennsylvania, USA, email: patricia.shearburn@lvh.com; Melissa Kratz, RN, MSN, AOCN
Abstract:
Administration/Leadership Development: The complexity of chemotherapy orders creates a high risk for error. The Agency for Healthcare Research and the Institute for Safe Medical Practice continue to report errors in chemotherapy ordering and administration. A hospital designed web based chemotherapy order program was implemented in 2004. This program produced a 20% reduction in transcription, mathematic and protocol errors. Implementation of an Oncology EMR occurred 3 years later. This was an opportunity to address other areas of potential error in chemotherapy ordering and improve patient safety. The purpose of this project was to identify errors and problematic areas in the care of the patient receiving chemotherapy, and to create Plans of Care to further reduce our error rate. A collaborative team of Physicians, Pharmacists, Staff Nurses, and Clinical Nurse Specialists, identified, through a review of patient event reports, and office call logs: missing or problematic orders and errors in chemotherapy ordering and administration. Pre-medications, hydrations, laboratory tests, support medications, prescriptions, and nadir visits were all identified as problem areas. A literature review provided empirical support for standardization and inclusion of these in our chemotherapy orders. Consensus was achieved and our chemotherapy orders were revised and expanded to Plans of Care. There are 593 Plans of Care developed. Each Plan of Care includes: drugs, admixture information, drug specific assessments and administration information, dose, route, rate, hydrations, teaching information, support drugs, laboratory assessments, physician visits, and patient prescriptions. Our chemotherapy associated event reports were reduced an additional 44%, this includes near miss events. Data entry errors remain. Errors in height/weight, documentation of dose reduction reasons, maintaining a dose reduction throughout the care plan, failure to press the re-calculate button for a laboratory or weight change, are some of the remaining errors. The majority of events were discovered by safety checks performed by the pharmacist or nurse prior to drug preparation and administration. Computer generated Care Plans reduced errors, as well as changed error types. It is important to recognize that errors can still occur in the EMR environment. Dual safety checks by the pharmacy and nursing continue to be paramount in error prevention.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleUtilization of Error Analysis Data in Chemotherapy Order Preparation for Development of a Comprehensive Electronic Chemotherapy Plan of Careen_GB
dc.contributor.authorShearburn, Patriciaen_US
dc.contributor.authorKratz, Melissaen_US
dc.author.detailsPatricia Shearburn, RN, MSN, AOCN, Oncology Clinical Nurse Specialist, Lehigh Valley Hospital, Allentown, Pennsylvania, USA, email: patricia.shearburn@lvh.com; Melissa Kratz, RN, MSN, AOCNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164805-
dc.description.abstractAdministration/Leadership Development: The complexity of chemotherapy orders creates a high risk for error. The Agency for Healthcare Research and the Institute for Safe Medical Practice continue to report errors in chemotherapy ordering and administration. A hospital designed web based chemotherapy order program was implemented in 2004. This program produced a 20% reduction in transcription, mathematic and protocol errors. Implementation of an Oncology EMR occurred 3 years later. This was an opportunity to address other areas of potential error in chemotherapy ordering and improve patient safety. The purpose of this project was to identify errors and problematic areas in the care of the patient receiving chemotherapy, and to create Plans of Care to further reduce our error rate. A collaborative team of Physicians, Pharmacists, Staff Nurses, and Clinical Nurse Specialists, identified, through a review of patient event reports, and office call logs: missing or problematic orders and errors in chemotherapy ordering and administration. Pre-medications, hydrations, laboratory tests, support medications, prescriptions, and nadir visits were all identified as problem areas. A literature review provided empirical support for standardization and inclusion of these in our chemotherapy orders. Consensus was achieved and our chemotherapy orders were revised and expanded to Plans of Care. There are 593 Plans of Care developed. Each Plan of Care includes: drugs, admixture information, drug specific assessments and administration information, dose, route, rate, hydrations, teaching information, support drugs, laboratory assessments, physician visits, and patient prescriptions. Our chemotherapy associated event reports were reduced an additional 44%, this includes near miss events. Data entry errors remain. Errors in height/weight, documentation of dose reduction reasons, maintaining a dose reduction throughout the care plan, failure to press the re-calculate button for a laboratory or weight change, are some of the remaining errors. The majority of events were discovered by safety checks performed by the pharmacist or nurse prior to drug preparation and administration. Computer generated Care Plans reduced errors, as well as changed error types. It is important to recognize that errors can still occur in the EMR environment. Dual safety checks by the pharmacy and nursing continue to be paramount in error prevention.en_GB
dc.date.available2011-10-27T12:07:19Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:07:19Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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