( y associated with errors were part of t...)Most Pediatric Chemotherapy Mistakes Reach Patients,Health

y associated with errors were part of the antimetabolite class (40 percent), which includes Methotrexate (15 percent) and Cytarabine (12 percent).

Almost half of all errors occurred in administration of the drug and errors were commonly related to improper dosing (23 percent), timing or frequency (23 percent). Interestingly, compared to inpatient facilities, outpatient clinics were more likely to involve prescribing and dose calculation errors. Over 40 percent of errors were attributed to a performance deficit while communication and knowledge deficits accounted for only 9 percent and 7 percent, respectively. Outpatient errors were more likely to be attributed to the delivery device, brand name similarities and stress.

Dr. Miller and her coauthors concluded that pediatric chemotherapy errors often reach the patient. These errors, they explained, were potentially harmful to the pediatric patient population and differed in quality between outpatient and inpatient oncology areas.

Since most of the errors occurred during administration of the drug, not prescribing, pediatric hospitals and future quality improvement research should target medication administration safeguards for these high risk medications and consider different and specific solutions for inpatient and outpatient pediatric oncology units respectively.


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