[Assessing quality in the process of using hazardous drugs-prescription and preparation].
OBJECTIVE
To evaluate the quality of cytotoxic drug prescription based on the results of an interventional pharmaceutical program and the quality of the final product based on quality-control prior to preparation.


METHODS



METHODS
July 2002-March 2003. Hazardous drug prescription was evaluated through an analysis of pharmaceutical interventions during therapeutical monitoring. Depending on repercussion in patients, they were classified in three categories (treatment optimization, resource optimization or criteria unification). Data obtained from manual quality control programs prior to hazardous drug preparation were evaluated.


RESULTS
Sixty-four interventions were made (9 interventions per 100 prescriptions): 55% were classified as treatment optimization, 28% as resource optimization and 17% as criteria unification. A total of 66% of the interventions focused on treatment optimization were caused by prescription errors. Ninety-seven per cent were accepted. Out of 2,074 preparations, 1,951 were evaluated (94.9%). A 5.1% of non-evaluated preparations were due to a lack of registration and 0.8% to violations in the established protocol.


CONCLUSIONS
Results of the interventional Pharmaceutical program show that an assisted prescription system is necessary, not only to detect prescription errors but also to prevent them. Manual controls in different stages of the process are useful and they should be complementary to other more reliable dosification controls.
Vuelta Arce
M
M
Servicio de Farmacia, Hospital Universitari Joan XXIII, Tarragona, Spain. mvuelta@hjxxiii.scs.es
Calabuig Muñoz
M
M
Jornet Montaña
S
S
Canadell Vilarrasa
L
L
Riera Sendra
G
G
Chumillas Chevalier
E
E
Gallart Mora
M J
MJ
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000191:economics; D011307:Drug Prescriptions / Q000191:economics* / Q000592:standards; D015386:Hazardous Substances; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000592:standards / Q000706:statistics & numerical data; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care
D000970:Antineoplastic Agents; D015386:Hazardous Substances