Article Text
Abstract
Background Implementation of new technologies in the drug administration phase (AP) is one of the recommendations suggested by most of the health agencies in order to prevent medication errors (ME).
Purpose To asses the effectiveness of a bar code assisted chemotherapy system (BCCS) in cancer patients.
Material and methods Prospective before and after study performed in a hospital centre in two phases. Over a 12 month period, ME in the administration were registered by review of the medication orders and medical history. The BCCS (ONCOSCAN) was designed and implemented. A follow-up period of another 12 months was assessed. The difference in rates of ME recorded before and after the BCCS system was implemented was analysed. The main purpose of this technology is to ensure that chemotherapy medication is administered correctly by scanning the bar codes and the preparation label of the medication orders, at the correct dose, at the correct time, at the correct infusion rate, to the correct patient.
Sample size was determined to identify an expected error reduction of ME with result of harm to patient of 75% and a type I error of 0.05 with 80% power. Student t tests were used to compare error rates between periods.
Results 500 patients were collected, 250 in each period. 6584 prescription lines were reviewed, 3240 in the first period and 3344 in the second period. There were no ME reported at AP in the medical history of the patient in the first period. After implementation of BCCS, 28 ME were detected and avoided (0.84% of intravenous mixtures; p < 0,01); 19 of them corresponded to the administration in a different order than established in the treatment protocol and 9 patients did not have the correct chemotherapy treatment to be administered. In every case the system sent out advice and 100% of ME detected were avoided.
Conclusion Bar code assisted chemotherapy systems allow identification of ME before they reach oncology patients, avoiding harm and increasing the safety of the care process.
No conflict of interest.