About the Project
Incidents with IV ambulatory chemotherapy, including the death of a patient in 2006 due to a fluorouracil overdose in Edmonton, have highlighted the safety risks of this particular therapy. Sponsored by the Canadian Patient Safety Institute (CPSI), the Canadian Association of Provincial Cancer Agencies (CAPCA), the Institute for Safe Medication Practices (ISMP) Canada, and five provincial cancer care agencies, Healthcare Human Factors conducted a pan-Canadian research study with the following objectives:
- Identify the current practices for ordering, preparing, labeling, verifying & administering ambulatory IV chemotherapy in Canada.
- Identify sources of risk in a wide variety of environments.
- Recommend strategies to reduce risks.
Multiple methodologies were employed to achieve these objectives, including a national survey of cancer care providers, field studies in six cancer treatment facilities across Canada and in-depth analyses of the key safety themes identified.
One of the main safety concerns identified was related to the use of preprinted orders. Preprinted orders (PPOs) are protocol-specific paper forms that contain standard medical orders. Although PPOs are the primary tool used for communicating ambulatory chemotherapy by Canadian cancer care providers, the study found that existing PPOs vary widely in format, content and layout and do not incorporate the flexibility required for the dynamic needs of oncology ordering practices.
To address these issues, Healthcare Human Factors collaborated with oncology clinicians and nine graphic designers from the Ontario College of Art and Design (OCADU) to develop the Guidelines for Developing Ambulatory Chemotherapy Orders.
The Guidelines for Developing Ambulatory Chemotherapy Orders have been widely circulated to the cancer care providers across Canada. In addition, two provincial cancer agencies have started applying the guidelines to improve their existing preprinted orders.
In The Press
- The full report on the study and the preprinted order guidelines on the Canadian Association of Provincial Cancer Agencies (CAPCA) website Read full article »