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Browsing by Subject "vaaratapahtumien raportointi"

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  • Koskinen, Kati (2013)
    Ensuring patient and medication safety is a widely acknowledged challenge in health care. Key concepts in medication safety are: a patient safety incident, a safety barrier, and a medication error. A patient safety incident is an incident which has led or could have led to harm for the patient. A safety barrier is a structure built into the medication use process, and it is designed to improve medication safety. A medication error is a deviation from the medication process. The medication safety of cancer patients is especially important. Chemotherapeutic agents usually have a narrow therapeutic index and they have toxic side effects even in therapeutic doses. Accordingly, chemotherapeutic agents are classified as high alert medications. This means that they have an increased risk for patient harm if used improperly. Cancer patients are often elderly people and they have comorbid diseases. As a result, they are more susceptible to adverse drug effects. Moreover, the use of anticancer drugs varies between patients and the different indications of a drug, and supportive therapies are often needed. Thus, cancer pharmacotherapy is complicated. In this registry study, safety in the medication process of cancer treatment was studied using voluntary patient safety incident reports in one university hospital district in Finland. The aim of this study was to describe medication errors in cancer treatment, and safety barriers in the medication use process. The reported medication safety incidents were analysed by combining quantitative and qualitative methods. Altogether 176 incident reports were analysed relating to the use of anticancer drugs and supportive therapies. The most common medication errors were administration (27 %), prescribing (11 %), and ordering errors (10 %). These medication errors were typically omission errors. There were safety barriers in the medication process, such as double-checking of medicines, but they were not always fully effective. Some barriers were missing, for example, computer programs lacked important safety features. Safety barriers are needed, and should be further developed especially in the prescribing, ordering and administration phases of the process. More effective barriers would increase patient and medication safety in cancer treatment. The classification of medication errors in patient safety incidents was not always correct. Therefore, reporting and analysing of reports should be improved. The results of this study can be utilised for improving medication safety in all organisations giving cancer pharmacotherapy.