As with every pharmacy service, the structure of oncology therapy management should be driven by safety. However, in addition to ensuring the safety of patients for whom even the slightest variability in dosage can have catastrophic effects, the hospital must also consider the safety of its staff when designing this service.
Ideally, automation should be brought to bear to mitigate the risk points inherent in handling cytotoxic medications. From electronic order entry systems that provide complete and clear order sets, accurate calculations, and correct routes of administration, to bar code scanning of each ingredient and digital recording of the amounts added during the compounding stage, automation can offset the risk of human error.
Likewise, CSTDs deliver additional safety to compounding and nursing staff. As Jennifer Reeves, RPh, points out in her article on page 2, priming every order set for nursing is another way to extend the safety benefits of these products.
Exploiting the benefits of automation is one method to bring oncology therapy management under tighter control, but all of the safety considerations that apply to non-hazardous drugs—such as independent, sequential double checks to avoid confirmation bias—are applicable in the oncology environment as well. Labeling safety is particularly important given how vulnerable these complex regimens are to a labeling error. Click here to find tips for safe labeling.
Standardized practices developed in conjunction with frontline staff and supported by automation will deliver increased safety for patients and staff alike. But ultimately, it is the commitment to constant improvement and a willingness to tackle the difficult issues that will ensure long-term safety. Just as you commit to constant improvement in your pharmacy practice, PP&P is committed to sharing the successes (and setbacks) of your peers who are taking on these difficult issues with you.
All the best,
R. Mitchell Halvorsen
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