Safe Administration of Chemotherapy: Safety During Chemotherapy Ordering, Transcribing, Dispensing, and Patient Identification

Guideline Objective

To provide guidance on processes, technologies, and devices for the prevention of errors during systemic cancer treatment administration in adult patients in areas that cut across the entire process and in the planning and preparation stages.

Patient Population

Adult patients who are going to receive chemotherapy treatment or who are already receiving chemotherapy treatment for cancer in hospital settings.

Intended Guideline Users

• Organizations that provide chemotherapy treatment to cancer patients.
• Clinicians and healthcare providers (e.g., nurses, pharmacists, physicians, clerks) involved with the administration of chemotherapy agents, and hospital administrators.

Research Question(s)

Environmental considerations:

• What are the best strategies to reduce distractions and interruptions during chemotherapy administration?

Patient identification:

• When, how often, and by whom should patients be identified?
• Which and how many pieces of information should be required for patient identification (ID)?
• What are the most effective technologies for patient identification? (wristbands, barcoding, radiofrequency identification systems, automated ID, data capture)

Patient information and education and role in plan of care:

• What are the pieces of information that need to be conveyed to the patients and their families, and what is the timing for information delivery, regarding the chemotherapy drugs that are going to be administered, or regarding any changes in treatment plan?
• What role do patients play in determining the plan of care? Is there a role for informed consent in safety outcomes?

CPOE:

• What is the most effective technology to reduce adverse drug events at the time of ordering, prescribing, and transcribing for chemotherapy drugs?

Checklists:

• Are checklists effective in preventing medication-related adverse events during the administration of chemotherapy agents?

Patient assessment:

• What are the essential components of patient assessment (for new and returning patients)?

Screening tools:

• What are the most effective screening tools for symptom assessment?

Written plan:

• What are the necessary parts of a written treatment plan?

Scheduling models:

• What is the most effective scheduling model for reducing errors in the administration of chemotherapy to cancer patients?

Pharmacy practices:

• What are the most effective pharmacy practices for reducing errors in the administration of chemotherapy to cancer patients?
• What are the most effective strategies to reduce errors in the packaging and transporting chemotherapy drugs?

Infusion pumps: 

• What is the most effective type of infusion pump for preventing errors during the administration of chemotherapy agents?