Background Errors with cytotoxic drugs in oncology can have serious consequences because of their narrow therapeutic index.

Purpose To compare the safety mechanisms available in all hospital pharmacies preparing cytotoxic drugs in our country. The main focus was on patient safety as well as the staff involved in the preparation.

Material and methods The survey was based on an anonymous online questionnaire, which contained 29 questions focusing on the organisation of work, amount, frequency and the type of preparation, prescription and preparation method and the safety of the pharmaceutical staff. The questionnaire was sent to all 37 hospital pharmacies with cytotoxic preparation units. All responses were evaluated and presented graphically, in absolute numbers and percentages.

Results 35/37 (94.6%) questionnaires were completed. 33 (94%) pharmacies prepare cytotoxic drugs for all hospital departments. 19 hospitals (54%) use a computerised physician order entry (CPOE) system. 77.2% of the pharmacists can see and check the protocol, patients’ body surface and the dose. 24 pharmacies (69%) also prepare monoclonal antibodies. Gravimetric control of the prepared dose is used in 3 (9%) pharmacies. 3 (9%) pharmacies use a robotic system for preparation. 4 (12%) pharmacies use barcodes to identify the material and the final product. 43% of the cytotoxic preparation units periodically record errors.

Conclusion Our questionnaire identified 38 critical points of the prescription and preparation process, each of them represents a contribution to safety of the chemotherapy process. The overall level of safety in the prescription and preparation of cytotoxic drugs is rather unbalanced in our country and varies from 6.3% to 87.5% (compared to the ideal state). We have proved that CPOE plays one of the key roles in eliminating chemotherapy errors. The data from this study will help when sharing experience among hospital pharmacies.

References and/or acknowledgements No conflict of interest.