Swiss Patient Safety Foundation, Zurich; University Hospital of Basel, Basel; and University of Bern, Bern, Switzerland.
J Oncol Pract. 2018 Apr;14(4):e201-e210. doi: 10.1200/JOP.2017.026427. Epub 2018 Feb 26.
To increase medication safety in oncology, checking procedures are increasingly applied by nurses, physicians, and pharmacists. However, little is known about the number, types, and consistency of implemented checks. The aim of the study was to assess the number and types of different checking procedures that are performed along the lifecycle of a chemotherapy prescription across three hospitals, different care settings, administration routes, and professional groups.
A scheme to evaluate checking procedures and a mapping approach to illustrate the checks along the phases of the medication process were developed. Checking procedures were assessed on the basis of analysis of internal guidelines and interviews with nurses and physicians who work on wards and in ambulatory infusion units of three hospitals.
There were considerable differences in number and type of checking procedures among administration routes, professional groups, wards and ambulatory infusion units, and hospitals. During the prescribing phase, the lowest number of checks was performed. In internal guidelines, checking procedures were documented poorly, though the pharmacy process was an exception.
In contrast to the pharmacists, nurse and physician clinician checking procedures are less standardized within and across hospitals. The results point to different checking habits for the professional groups; for example, physicians would rather perform plausibility reviews than checks. Our evaluation scheme to categorize checks and the visualized mapping approach was feasible and understandable for practitioners.
为了提高肿瘤学中的用药安全性，护士、医生和药剂师越来越多地采用核对程序。然而，对于实施的核对数量、类型和一致性知之甚少。本研究的目的是评估在三家医院、不同护理环境、给药途径和专业群体中，在化疗处方生命周期中执行的不同核对程序的数量和类型。
制定了评估核对程序的方案和图示方法，以说明药物治疗过程各阶段的核对情况。根据对在三家医院的病房和门诊输液单元工作的护士和医生的内部指南分析和访谈，评估核对程序。
给药途径、专业群体、病房和门诊输液单元以及医院之间的核对程序数量和类型存在相当大的差异。在处方阶段，执行的核对程序最少。内部指南中，核对程序记录不佳，但药房流程是个例外。
与药剂师相比，护士和医生临床医生的核对程序在医院内和医院间的标准化程度较低。结果表明，不同专业群体有不同的核对习惯；例如，医生更愿意进行合理性审查而不是核对。我们的核对程序分类评估方案和可视化映射方法对于从业者来说是可行且易于理解的。
