Chemotherapy patients' perceptions of drug administration safety

Chemotherapy patients' perceptions of drug administration safety.
Schwappach DLB, Wernli M. J Clin Oncol. 2010 May 10; [Epub ahead of print].

This survey of outpatient chemotherapy patients revealed a high degree of concern about medication errors, and most patients expressed a desire to take an active role in ensuring their own safety.

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Health Services and Outcomes


Chemotherapy Patients' Perceptions of Drug Administration Safety
David L.B. Schwappach, Martin Wernli
From the Swiss Patient Safety Foundation, Zürich; Institute of Social and Preventive Medicine, University of Bern, Bern; and Kantonsspital Aarau, Aarau, Switzerland.

Corresponding author: David L.B. Schwappach, PhD, MPH, Swiss Patient Safety Foundation, Asylstr 77, 8032 Zürich, Switzerland; e-mail: schwappach@patientensicherheit.ch.

ABSTRACT

Purpose To explore chemotherapy patients' experiences of drug administration safety and to investigate the relationship between perceptions of risk and harm from error, staff safety practices, and patients' engagement in error prevention strategies.

Patients and Methods Four hundred seventy-nine chemotherapy patients treated at the oncology/hematology department of a large regional hospital in Switzerland completed a self-administered survey (53% response rate).

Results Sixteen percent of patients reported having experienced an error in their care, and 11% were currently very concerned about errors. Patients perceived the risk of four detailed errors as rather low, whereas the mean rating of potential harm from error was substantial. Relative to other errors, patients seem to underestimate the harm associated with drug overdosing. Seventy-seven percent of responders agreed that patients can help to prevent errors. Although patients perceived staff as being committed to providing safe care, ratings related to patient involvement in safety were considerably lower. More than one quarter of patients disagreed that staff instructed them to watch for and report errors. Patients engaged in safety behaviors, particularly in those behaviors that are compatible with traditional patient-provider relations. Risk of error perceptions, affirmative attitudes toward patient preventability, and error experience were positively linked to safety-related behaviors, whereas higher levels of global trust in staff safety practices were inconsistently associated with lower frequency of engagement in safety strategies.

Conclusion Chemotherapy safety is a considerable concern for patients. Many patients are prepared to be involved in error prevention. The results highlight areas for improvement in communication and cooperation for safety between patients and providers.

http://jco.ascopubs.org/cgi/content/abstract/JCO.2009.27.6626v1