The impact of introducing pre-printed chemotherapy medication charts to a day chemotherapy unit

Abstract

Context. The cytotoxic regimens used in the contemporary day chemotherapy unit are often complicated and present numerous opportunities for error, inadvertent misadventure in prescription orders and variations in drug administration. The introduction of pre-printed chemotherapy charts for each protocol was introduced to minimise incorrect or incomplete prescribing by medical staff. Objective. To assess the benefits of introducing pre-printed chemotherapy charts into a day chemotherapy unit. Method. Commonly used protocols in the unit were assessed and assembled into pre-printed chemotherapy charts. The doses and administration details of each protocol were reviewed by chemotherapy nursing staff, medical staff and the oncology pharmacist before the charts were finalised. Clinical interventions performed by the oncology pharmacist were recorded for 1 month prior and 1 month following the introduction of the pre-printed charts. Nursing and medical staff were surveyed on their level of satisfaction with the pre-printed chemotherapy charts. Results. Prior to the introduction of the pre-printed charts, 74% of chemotherapy charts were problematic requiring multiple pharmacy interventions per chart. After the introduction of the pre-printed charts, 43% of charts were problematic requiring an average of one pharmacy intervention per chart. Pharmacy interventions were significantly reduced, which has resulted in a significant reduction in workload for the oncology pharmacist. The medical and nursing staff strongly supported the introduction of the pre-printed charts. There has been a reduction in the variation of orders amongst medical officers, reduction in prescribing errors, decreased anxiety amongst staff and better work-flow in the Day Chemotherapy Unit. Conclusion. Pre-printed chemotherapy medication charts have promoted a more methodical approach to the prescribing and administration of chemotherapy, which has resulted in a more efficient day chemotherapy unit.