AuthorDougherty Soper, Katelynn G.
AdvisorEdwards, Lori A.
MetadataShow full item record
Other TitlesChemotherapy Administration Checklist
AbstractProblem: Chemotherapeutic medication errors have previously been described as the second most common cause of fatal medication errors. On an inpatient oncology unit, two near-misses related to chemotherapy administration posed a threat to both patients’ and nurses’ safety. Furthermore, 83% of inpatient oncology nurses reported a lack of confidence in safe chemotherapy administration processes. A low volume of chemotherapy patients, an outdated Chemotherapy Administration Checklist and a lack of familiarity with current hospital policies and resources were identified as contributing factors. Purpose: The purpose of this evidence-based quality improvement project was to implement and evaluate the effectiveness of a Chemotherapy Administration Checklist on a 32-bed inpatient oncology unit. The intended outcome was to standardize the chemotherapy administration and documentation processes in accordance with national guidelines while improving nursing confidence and preventing patient harm. Methods: The 2016 ASCO/ONS Chemotherapy Administration Safety Standards were used to revise the Chemotherapy Administration Checklist in the electronic medical record (EMR) at a small urban community hospital. Chemotherapy certified nurses on the inpatient oncology unit were trained on the revised checklist as well as the new processes for chemotherapy administration and documentation. Weekly chart audits were conducted to track checklist utilization and chemotherapy associated nursing documentation. A pre/post survey was conducted to assess nurses’ experience of chemotherapy administration. Results: Nurses successfully documented on the new Chemotherapy Administration Checklist 73% (n=11) of the time. Nurses’ self-reported confidence in being able to safely administer chemotherapy increased from 47% (n=15) pre- to 86% (n=14) post-implementation. There have been no recorded chemotherapy administration errors since implementation. Chemotherapy associated nursing documentation remains variable. The most frequently missed areas of documentation include: intake flowsheets (58%), nursing care plans (70%), patient education (67%) and the chemotherapy administration note template (73%). Conclusions: Implementation of a Chemotherapy Administration Checklist into the EMR streamlines chemotherapy administration and nursing documentation processes in accordance with ASCO/ONS guidelines, while improving nursing confidence and preventing patient harm. Continued variability in nursing documentation suggests additional interventions are needed to ensure all chemotherapy associated documentation is completed with each chemotherapy administration.
Keywordchemotherapy administration checklist
Antineoplastic Agents--administration & dosage