What is chemotherapy dosing error?
Chemotherapy dosing error is a serious and potentially fatal mistake that can occur during the treatment of cancer. Chemotherapy dosing error can happen at any stage of the medication use process, such as prescribing, order communication, product labeling, compounding, dispensing, administration, education, and monitoring. Some of the common causes and consequences of chemotherapy dosing error are:
🟢- Chemotherapy given to wrong patient⁴
🟢- Wrong application (e.g. wrong or missing use of aseptic techniques in IV chemotherapy, missing inline filter)⁴
🟢- Application order not checked⁴
🟢- Missing or wrong communication⁴⁵
🟢- Missing patient education⁵
🟢- Incorrect dosing due to miscalculation of body surface area (BSA) or protocol dosage³
🟢- Inadvertent intrathecal chemotherapy administration²
🟢- Prescribing errors related to oral chemotherapy regimens⁵
Chemotherapy dosing error can lead to severe side effects, such as nausea, vomiting, diarrhea, hair loss, infection, bleeding, organ damage, or death⁵. Therefore, it is essential to follow the quality and safety standards in chemotherapy administration, such as the ones developed by the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS)². These standards provide evidence-based recommendations for the safe use of chemotherapy and biotherapy agents in cancer treatment, such as:
🟢- Establishing a culture of safety and accountability
🟢- Implementing standardized policies and procedures for chemotherapy ordering, preparation, and administration
🟢- Using computerized prescriber order entry (CPOE) systems with clinical decision support
🟢- Performing independent double-checks by qualified personnel
🟢- Providing patient education and counseling
🟢- Monitoring and reporting medication errors and adverse events
By following these standards, healthcare providers can reduce the risk of chemotherapy dosing error and improve the quality and safety of cancer care.
How to fix chemotherapy dosing error?
Chemotherapy dosing errors are serious and can have significant consequences. Chemotherapy drugs are potent and are used to treat cancer, but they can also harm healthy cells if not administered correctly. If you suspect a chemotherapy dosing error or are concerned about one, here's what you should do:
✅1. **Contact Your Healthcare Team**: If you are receiving chemotherapy and suspect a dosing error, immediately contact your healthcare team, including your oncologist or the nurse administering the treatment. Communicate your concerns and provide all the necessary information about the error.
✅2. **Document the Error**: Write down the details of the suspected dosing error, including the date, time, drug name, dosage, and any other relevant information. Documentation can be valuable for your healthcare team in assessing the situation.
✅3. **Seek Immediate Medical Attention**: Depending on the severity of the suspected error, your healthcare team may recommend that you seek immediate medical attention. They will assess your condition and determine the appropriate course of action.
✅4. **Discuss Potential Consequences**: Talk to your healthcare team about the potential consequences of the dosing error. They can provide you with information about the expected effects and any necessary treatments or interventions.
✅5. **Review the Prescription**: If you have a copy of the chemotherapy prescription or medication order, review it with your healthcare team. Confirm that the dosing instructions on the prescription match the actual administration.
✅6. **Ask for an Explanation**: Ask your healthcare team to explain the circumstances that led to the dosing error. Understanding what went wrong can help prevent similar errors in the future.
✅7. **Patient Advocacy**: Be an advocate for your own health. If you feel that a mistake has been made, it's crucial to speak up and seek appropriate care and treatment.
✅8. **Follow-up Care**: Your healthcare team will develop a plan for managing the situation and any potential side effects of the dosing error. Follow their guidance for continued care.
✅9. **Preventive Measures**: Discuss measures with your healthcare team to help prevent dosing errors in the future, such as double-checking medication orders, using technology to support dosing calculations, and improving communication among the healthcare team.
✅10. **Reporting the Error**: Depending on your location, there may be reporting mechanisms for medication errors. You or your healthcare team may need to report the dosing error to the appropriate regulatory or oversight body.
It's important to remember that healthcare professionals are committed to patient safety, and they take dosing errors seriously. They will work to address and rectify any mistakes and provide you with the appropriate care and support. Open and honest communication with your healthcare team is key when addressing chemotherapy dosing errors.
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