Background As the cytostatic medicines are a group of drugs with a narrow therapeutic index, it is necessary to develop new mechanisms to improve safety from prescription to administration in the hospital in order to avoid fatal errors.
Purpose To develop a system that ensures that the prescription process, production and administration of cytostatic drugs meet the criteria: right patient, medicine, dosage, route of administration and time.
Materials and Methods Along with the centralization of drugs preparation in the pharmacy service, a computer system has been designed for the management of the administration of cytostatic drugs consisting of: portable digital assistant (PDA) with barcode reader, label printer for barcoded medicines, patient-identifying wristband and dedicated software for verifying and recording administration.
Results Every chemotherapy prescription is sent to the cytotoxic admixture unit mixer where it is validated by a pharmacist checking the following items: name and number from the patient history, diagnosis, stage, line of treatment, drugs, dose and route of administration. The computer programme generates drug labels containing the bar code which identifies the preparation. Each patient has a label with the bar code of the history number. Before the administration of each cycle, the responsible nurse has to read the patient bar code with the PDA. The drug and the right order for that patient will appear on the screen of the device. Nurses should read the bar code of each drug to be administered and the system cheques that it is the right medicine and order, alerting visually and acoustically if error occurs. The system records the nurse and time of each drug administration.
Conclusions The project was implemented due to the need for safety mechanisms in the management of high-risk medicines, as cancer treatments are group of drugs with a narrow therapeutic index.
The system cheques the safety in five key areas: patient, medicine, dose, route of administration and time.
No conflict of interest.
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