A pilot study about methods to reduce prescription errors in a chemotherapy day unit – Aspects to consider in pharmacist verification process

2021 ◽  
pp. 107815522110665
Author(s):  
Asta Kähkönen ◽  
Sanna Eestilä ◽  
Kirsi Kvarnström ◽  
Riikka Nevala
Keyword(s):  
Medication Errors ◽  
Clinical Pharmacist ◽  
University Hospital ◽  
Medical Documentation ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Prescribing Errors ◽  
Common Error ◽  
Training Requirements ◽  
Clinically Significant

Introduction Prescribing errors can happen unintentionally during the prescribing process, or when choosing a treatment therapy. Prescribing errors have the highest prevalence amongst common error types related to chemotherapy medication in outpatient settings. According to the Joint Commission International (JCI), prescriptions should be reviewed for appropriateness by someone else than the prescriber or practitioner to prevent medication errors. Aim The study was aimed to map out the existing type and amount of occurring deviations in prescribing and to clarify the current chemotherapy prescribing practices at the Comprehensive Cancer Center at Helsinki University Hospital. Similar research has not been published in Finland before. Methods and patients The researcher selected patients randomly from the daily outpatient attendance list following a predetermined numerical order. Data was collected by conducting a medication verification review in line with the JCI guidance by a clinical pharmacist the day before the patient's clinic appointment using the available medical documentation. A clinical pharmacist evaluated findings from prescriptions and contacted an oncologist if the findings were considered clinically significant. Results A clinical pharmacist verified prescriptions from 101 patients for appropriateness and found discrepancies in four percent of the prescriptions ( n = 4/101). The oncologist approved 50 percent of the suggested amendments by the pharmacist as clinically significant ( n = 2/4). The study revealed that patient’s regular home medications were not always correctly recorded into the database, so verification of medicine interactions could not be trusted as completely accurate. It took on average 16 min per patient to perform a medication verification review. The process was slowed down by the lack of detailed enough protocols for this purpose and the current patient care record system not having structural formatting of data entry. Conclusions Verification of prescriptions provides a tool to identify prescribing discrepancies and to prevent unintended medication errors affecting patients. The development of detailed protocols and guidelines, as well as an appropriate training program, would support pharmacists in compiling clinical medication reviews for chemotherapy patients. More research is needed to further develop the operating model in Finland. Information gathered from this study can be used for identifying training requirements.

scholarly journals Observational analysis of medication related errors by clinical pharmacists in a South Indian hospital

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Syamprashanth Pedada ◽  
Jyotsna Allamsetty ◽  
Meena Ujwala Garikapati ◽  
Navya Burreddy ◽  
Umasankar Viriti
Keyword(s):  
Medication Errors ◽  
Health Care Providers ◽  
Clinical Pharmacist ◽  
General Medicine ◽  
Case Report Form ◽  
Care Providers ◽  
Prescribing Errors ◽  
Standard Case ◽  
Patient Interview ◽  
South Indian

Present work was done to evaluate the occurrence of medication errors in general ward of institute of medical sciences to assess the role of clinical pharmacist in error management. The study was conducted for 9 months and Data was acquired from inpatients of general medicine dept by using standard case report form through direct patient interview. The collected data was to identify medication errors by using drug information tools such as , drug interaction checker and reputed journals and statistical interpretations were done. 400 prescriptions were and in that 300 prescriptions were presented with medication errors. 202 were found to be Prescribing errors, 111 Administration errors,45 were dispensing errors, Monitoring errors were 123. Interaction errors (81.18%), prescription in small letters (34.65%), wrong frequency of administration error (32.43%) and wrong time administration of medicine (85.58%), Dispensing wrong quantity of drug (95.5%) were the major medication errors that were observed. Medication errors have been occurring frequently in the general medicine department out of which prescribing errors were more common. Clinical Pharmacist could act as an medical staff by performing consciousness and teaching to medical professionals and by maintaining positive collaboration with other health care providers for patients.

Commentary on: “Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): A multicentre, randomised, double-blind, phase 3 trial.” Kwon ED, Drake CG, Scher HI, Fizazi K, Bossi A, van den Eertwegh AJ, Krainer M, Houede N, Santos R, Mahammedi H, Ng S, Maio M, Franke FA, Sundar S, Agarwal N, Bergman AM, Ciuleanu TE, Korbenfeld E, Sengeløv L, Hansen S, Logothetis C, Beer TM, McHenry MB, Gagnier P, Liu D, Gerritsen WR, CA184-043 Investigators. Departments of Urology and Immunology and Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Rochester, MN, USA, Electronic address: [email protected]; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and Brady Urological Institute, Baltimore, MD, USA; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA; Institut Gustave Roussy, University of Paris-Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France; VU University Medical Centre, Amsterdam, Netherlands; Vienna General Hospital, Medical University Vienna, Vienna, Austria; Institut Bergonié, Bordeaux, France; CHU Caremeau, Nimes, France; Centro Médico Austral, Buenos Aires, Argentina; Centre Jean Perrin, Clermont-Ferrand, France; St John of God Hospital, Subiaco, WA, Australia; University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy; Hospital de Caridade de Ijuí, Ijuí, Brazil; Nottingham University Hospital, Nottingham, UK; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Institute of Oncology Ion Chiricuta and University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania; Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Herlev Hospital, Herlev, Denmark; Odense University Hospital, Odense, Denmark; University of Texas MD Anderson Cancer Center, Houston, TX, USA; Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA; Bristol-Myers Squibb, Wallingford, CT, USA; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.

2016 ◽  
Vol 34 (5) ◽  
pp. 249-250 ◽  
Author(s):  
Donald Trump
Keyword(s):  
Mayo Clinic ◽  
Buenos Aires ◽  
Salt Lake ◽  
Health Science ◽  
Medical Centre ◽  
University Hospital ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Castration Resistant Prostate Cancer ◽  
Double Blind

scholarly journals Obstacles to Clinical Research

2018 ◽  
Vol 14 (2) ◽  
pp. 61
Author(s):  
John L Marshall ◽  
Keyword(s):  
Clinical Care ◽  
Molecular Medicine ◽  
University Hospital ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Gastrointestinal Cancers ◽  
Patient Centered ◽  
Global Leader ◽  
Founding Director ◽  
Associate Director

John Marshall, MD, is a global leader in the research and development of drugs for colon cancer and other gastrointestinal cancers. He has been the principal investigator of over 150 clinical trials at local, as well as national, levels. Dr Marshall is the clinical director of oncology for Georgetown University Hospital, associate director for clinical care of the Lombardi Comprehensive Cancer Center, and chief of the Division of Hematology-Oncology. In 2009, Dr Marshall became the founding director of the Otto J Ruesch Center for the Cure of Gastrointestinal Cancers. Combining expertise in molecular medicine, translational research, and a patient-centered philosophy, the Ruesch Center is dedicated to realizing the dream of individualized curative therapies through research, care, and advocacy.

The University of Southern California penile cancer experience: Clinicopathologic characteristics of patients from 1991 to 2011.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 342-342
Author(s):  
Isuru Sampath Jayaratna ◽  
Rachel L. Schwartz ◽  
Anirban Pradip Mitra ◽  
Jie Cai ◽  
Yanling Ma ◽  
...  
Keyword(s):  
Lymph Node ◽  
Disease Process ◽  
Small Sample ◽  
Age At Diagnosis ◽  
University Hospital ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Lymph Node Yield ◽  
Stage Distribution ◽  
Poorly Differentiated

342 Background: Penile squamous cell carcinoma (PSCC) is a disfiguring and deadly disease. USCS data has shown an increased incidence in specific US minority communities. Methods: After IRB approval, a retrospective review of patients treated for PSCC at LAC-USC Medical Center, USC University Hospital, and Norris Comprehensive Cancer Center from 1991 to 2011 was completed. Patient characteristics were evaluated with descriptive statistics and contingency analyses. Results: Of 69 patients identified with PSCC, 64 had surgical staging information available. Median follow up was 18 months (range 0 – 161). Median age at diagnosis was 50 (range 23–86), with 50.7% of patients ≥50 and 49.3% <50 at diagnosis. Hispanic patients represented 71% (n=44) of our cohort. 44 patients underwent partial penectomy, 10 total penectomy and 8 had [1]a diagnostic biopsy. T stage distribution was Tis: 7.8% (n=5), T1: 39.1% (n=25), T2: 29.7% (n=19), T3: 18.8% (n=12), T4: 1.6% (n=1) and unknown: 3.1% (n=2). 38 groins were surgically evaluated, and 14 pelvic lymph node dissections were performed. Of the 24 patients who underwent a surgical lymph node evaluation. The N stage distribution was N1: 41.7% (n=10), N2: 12.5% (n=3) and N3: 45.8% (n=11). Median lymph node yield in groin dissections was 11, with a lymph node positivity rate of 49%. 30.8% (n=20), 41.5% (n=27), 12.3% (n=8) and 15.4% (n=10) of patients had well, moderately, poorly differentiated PSCC or unknown grade, respectively. There was no association of age (p=0.16) or race (p=0.24) with clinical stage. Stage was significantly associated with grade (p=0.049), with 75% of poorly differentiated tumors being Stage 4, compared with 21.4% of well-moderately differentiated tumors. Conclusions: In our cohort, we found a primarily Hispanic ethnic prevalence, which is reflective of our patient population, as well as a younger age at diagnosis in contrast to previously published reports. We observed a higher average stage in both T and N stages in our population compared with national averages. It is noted that the small sample size limits our power to draw conclusions, however this initial description of our population suggests variation in the disease process that may be related to demographic factors.

scholarly journals Urologic Oncology Patient Perspectives During COVID-19 Treatment Delays

2021 ◽  
Author(s):  
Anna Faris ◽  
Lindsey Herrel ◽  
James Montie ◽  
Stephanie Chisholm ◽  
Ashley Duby ◽  
...  
Keyword(s):  
Treatment Delay ◽  
Ordinal Scale ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Oncology Patient ◽  
Urologic Oncology ◽  
Personalized Care ◽  
Phone Calls ◽  
Urologic Cancer ◽  
Clinically Significant

Abstract Purpose The COVID-19 pandemic led to delays in urologic cancer treatment. We sought the patient perspective on these delays. Methods We conducted a mixed methods study with an explanatory-sequential design. Survey findings are presented here. Patients from a Midwestern Comprehensive Cancer Center and the Bladder Cancer Advocacy Network provided demographic and clinical data and responded to statements asking them to characterize their experience of treatment delay, patient-provider communication and coping strategies. We quantified patient distress with an ordinal scale (0-10), based on the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT). Results Forty-four consenting patients responded to the survey. Most were older than 61 years (77%) and male (66%). Their diagnoses included bladder (45%), prostate (30%) and kidney (20%) cancers. Median time since diagnosis was 6 months, 95% had plans for surgical treatment. Dominant reactions to treatment delay included fear that cancer would progress (50%) and relief at avoiding COVID-19 exposure (43%). Most patients reported feeling that their providers acknowledged their emotions (70%), yet 52% did not receive follow up phone calls and only 55% felt continually supported by their providers. Patients’ median distress level was 5/10 with 68% of patients reaching a clinically significant level of distress (≥4). Thematically grouped suggestions for providers included better communication (18%), more personalized support (14%), and better patient education (11%). Conclusion During the COVID-19 pandemic, a high proportion of urologic cancer patients reached a clinically significant level of distress. While they felt concern from providers, they desired more engagement and personalized care.

Medication safety in cancer clinical trials: An analysis of medication error reports at a comprehensive cancer center

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6547-6547 ◽  
Author(s):  
M. P. Kane ◽  
K. Fessele ◽  
J. Gordilis-Perez ◽  
S. Schwartz ◽  
S. Lisi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Medication Errors ◽  
Education And Training ◽  
Standards Of Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Healthcare Team ◽  
Improvement Project ◽  
And Training

6547 Background: Although medication errors comprise 10–25% of all medical errors, little is known concerning the occurrence or types of medication errors occurring while treating patients on a clinical trial. Therefore, we retrospectively reviewed the medication errors reported in patients enrolled on clinical trials at our center. Methods: As part of a multidisciplinary continuous quality improvement project, from January 2003 through December 2006, we collected voluntary reports of medication errors in adult and pediatric patients on clinical trials involving both oral and intravenous chemotherapy. All reports were classified prospectively regarding clinical trial involvement, severity category (A to I) per the National Coordination Council on Medical Error Reporting and Prevention, type, cause, and where in the medication use process the error occurred. Results: There were 163 reports involving patients treated on clinical trials. The most common errors were those corrected prior to reaching the patient in 68% of events (Category A&B), while 31% reached the patient but did not result in harm (Category C&D), with 1% resulting in temporary patient harm (Category E&F). The most common type of errors were prescribing (66%), improper dose (42%), and omission errors (9%). Not following an institutional procedure or the protocol was the primary cause for these errors (39%), followed by the written order (30%), and poor communication involving both the healthcare team and the patient (26%). The processes where the errors initiated were in prescribing 47%, administration 10%, dispensing 6%, and monitoring 5%. Conclusion: Medication errors do occur in clinical trials, however the majority of these are corrected prior to reaching the patient or do not result in harm. Not following an institutional procedure or the protocol was the most common cause of error. This is most likely due to the protocol procedures differing from existing standards of care. Protocol-specific education through the Centralized Education and Training Service, a shared resource within our cancer center, addresses this issue enhancing the quality and safety of clinical trials through the education and training of healthcare professionals. No significant financial relationships to disclose.

Residents' attitudes and beliefs towards palliative care in a community teaching hospital.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 89-89
Author(s):  
Sufana Shikdar ◽  
Noel Medeiros ◽  
Erin Kelly ◽  
Nicholas Ghionni ◽  
Deborah Cassidy ◽  
...  
Keyword(s):  
Palliative Care ◽  
Teaching Hospital ◽  
University Teaching ◽  
University Hospital ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Fisher Exact Test ◽  
Attitudes And Beliefs ◽  
Residents Attitudes ◽  
Community Teaching

89 Background: Early integrated palliative care improves the quality of life in patients with cancer. Wong et al. (2016) recently demonstrated that residents and fellows in a university hospital-based large comprehensive cancer center believed palliative care services to be beneficial for patient care. However, there are substantial differences between the clinical learning environments of a university and community teaching hospital. We aim to assess residents' attitudes and beliefs towards palliative care in the oncologic population in a community teaching hospital. Methods: We surveyed all residents (n = 90) in Mercy Catholic Medical Center's internal medicine, transitional year, and general surgery residencies about their knowledge, training, attitudes and beliefs regarding palliative care using a survey modified from Wong et al. (2015). Mercy Catholic Medical Center is a conglomeration of two community teaching hospitals in greater Philadelphia. The factors associated with awareness were analyzed using chi square or fisher exact test and logistic regression. Results: A total of 57 (63%) residents participated. The differences between the knowledge of residents from other specialties were not statistically significant. The awareness was reported more among residents who are American medical graduates (p = 0.03). The majority of the residents believed palliative care was beneficial to patients and families (98%), reduce health care costs (91%), decrease overall symptom burden (86%) and symptomatic management in newly diagnosed cancer (81%). Residents who reported having palliative care training during residency had significantly higher awareness (OR = 2.99, p = 0.04). Conclusions: Our study shows that the attitude and belief of residents at community teaching hospital is similar to the trainees at university teaching hospital. The implementation of palliative care rotation for all residents from clinical specialties can be effective in improving trainee’s attitude and belief regarding increased and early referral to palliative care.

scholarly journals Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers

2020 ◽  
Vol 19 ◽  
pp. 153473542094160
Author(s):  
Gabriel Lopez ◽  
Santhosshi Narayanan ◽  
Aimee Christie ◽  
Catherine Powers-James ◽  
Wenli Liu ◽  
...  
Keyword(s):  
Tai Chi ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Qi Gong ◽  
Cancer Symptoms ◽  
Significant Difference ◽  
Edmonton Symptom Assessment Scale ◽  
Clinically Significant ◽  
Global Distress

Background: There is increasing interest in complementary approaches such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the effects of TC/QG delivered in group classes at a comprehensive cancer center. Methods: Patients and caregivers who participated in TC or QG completed assessments before and after an in-person group class. Assessments included questions about expectancy/satisfaction and common cancer symptoms (Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed included global (GDS), physical (PHS), and psychosocial (PSS). Results: Three hundred four participants (184 patients, 120 caregivers) were included in the analysis. At baseline, caregivers had a greater expectancy for change in energy level as a result of class participation compared with patients (22.9% vs 9.9%). No significant difference was observed between baseline patient and caregiver PSS. Clinically significant improvement in well-being was observed among patients in TC classes (1.0) and caregivers in QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating in QG experienced clinically significant improvement. Both TC and QG classes were associated with clinically significant improvements (ESAS GDS decrease ≥3) in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of participants responded that their expectations were met. Conclusions: Patients and caregivers participating in TC or QG group classes were satisfied overall and experienced significant improvement in global distress. Additional research is warranted to explore the integration of TC and QG in the delivery of supportive cancer care.

General epidemiology and survival rate of malignant and non-malignant brain and central nervous system tumors in Nice area (France)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17078-17078
Author(s):  
E. Chamorey ◽  
C. Lebrun ◽  
D. Fontaine ◽  
F. Vandenbos ◽  
J. Michiels ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Data Base ◽  
Germ Cell Tumors ◽  
The United States ◽  
University Hospital ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Central Nervous System Tumors ◽  
Nervous System Tumors

17078 Background: The aim of this cohort study was to produce descriptive epidemiological data from the Group of Neuro- Oncology of Nice (GNON) database. Data were collected from the Comprehensive Cancer Center and the University Hospital of Nice (France). Methods: All cases that have been discussed during multidisciplinary meetings of neuro-oncology were entered. Data were compared with the Central Brain Tumor Registry of the United States (CBTRUS) report taken as reference tool. Follow-up information was obtained from the patient medical chart and from the national death registry. Results: 1,395 patients (718 males, 677 females) were registered in the data base. There were 938 tumors of neuroepithelial tissue (percentage of all reported cases in our study: 67.9%, median age in our study; 58 yrs, percentage in CBTRUS report: 43.6%, median age in CBTRUS report: 53 yrs), 55 tumors of cranial and spinal nerves (4.0%, 53 yrs; 8%, 52 yrs), 270 tumors of meninges (19.5%, 59 yrs; 31.4%, 63 yrs), 54 lymphoma and hemopoietic neoplasm (3.9%, 68 yrs; 3.1%, 60 yrs), 16 germ cell tumors, cysts and heterotopias (1.2%, 17yrs; 0.6%, 16yrs), 12 craniopharyngioma (0.9%, 50 yrs; 0.7%, 48 yrs), 9 chordoma/chondrosarcoma (0.6%, 65 yrs; 0.2%, 48 yrs), 27 unclassified tumors (2.0%, 46 yrs; 6.1%, 68 yrs). The table shows the survival rates at one, three and five years respectively for some selected brain and central nervous system tumors (results from the CBTRUS report in parentheses). Conclusions: A comparison between results from the CBTRUS and GNON data base showed some similarities and didn't point out any major unexplainable discrepancy. [Table: see text] No significant financial relationships to disclose.

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