Swiss Patient Safety Foundation, Asylstr 77, 8032 Zürich, Switzerland.
J Clin Oncol. 2010 Jun 10;28(17):2896-901. doi: 10.1200/JCO.2009.27.6626. Epub 2010 May 10.
To explore chemotherapy patients' experiences of drug administration safety and to investigate the relationship between perceptions of risk and harm from error, staff safety practices, and patients' engagement in error prevention strategies.
Four hundred seventy-nine chemotherapy patients treated at the oncology/hematology department of a large regional hospital in Switzerland completed a self-administered survey (53% response rate).
Sixteen percent of patients reported having experienced an error in their care, and 11% were currently very concerned about errors. Patients perceived the risk of four detailed errors as rather low, whereas the mean rating of potential harm from error was substantial. Relative to other errors, patients seem to underestimate the harm associated with drug overdosing. Seventy-seven percent of responders agreed that patients can help to prevent errors. Although patients perceived staff as being committed to providing safe care, ratings related to patient involvement in safety were considerably lower. More than one quarter of patients disagreed that staff instructed them to watch for and report errors. Patients engaged in safety behaviors, particularly in those behaviors that are compatible with traditional patient-provider relations. Risk of error perceptions, affirmative attitudes toward patient preventability, and error experience were positively linked to safety-related behaviors, whereas higher levels of global trust in staff safety practices were inconsistently associated with lower frequency of engagement in safety strategies.
Chemotherapy safety is a considerable concern for patients. Many patients are prepared to be involved in error prevention. The results highlight areas for improvement in communication and cooperation for safety between patients and providers.
探讨化疗患者对给药安全的体验，调查风险感知与差错危害、医护人员安全措施以及患者参与差错预防策略之间的关系。
瑞士一家大型地区医院肿瘤/血液科的 479 名化疗患者完成了一份自我管理调查（回应率为 53%）。
16%的患者报告在护理过程中经历过差错，11%的患者目前非常担心差错。患者对 4 种详细差错的风险感知较低，而对差错潜在危害的平均评分较高。与其他差错相比，患者似乎低估了药物过量相关的危害。77%的受访者同意患者可以帮助预防差错。尽管患者认为医护人员致力于提供安全护理，但与患者参与安全相关的评分要低得多。超过四分之一的患者不同意医护人员指示他们观察和报告差错。患者采取了安全行为，特别是那些与传统医患关系相符的行为。差错风险感知、对患者可预防差错的积极态度以及差错体验与安全相关行为呈正相关，而对医护人员安全措施的总体信任程度较高则与安全策略参与频率较低不一致相关。
化疗安全是患者的一个重要关注点。许多患者愿意参与差错预防。研究结果突出了在患者与医护人员之间为安全进行沟通和合作方面有待改进的地方。
