Chemotherapy patients' perceptions of drug administration safety.
OBJECTIVE
To explore chemotherapy patients' experiences of drug administration safety and to investigate the relationship between perceptions of risk and harm from error, staff safety practices, and patients' engagement in error prevention strategies.


METHODS
Four hundred seventy-nine chemotherapy patients treated at the oncology/hematology department of a large regional hospital in Switzerland completed a self-administered survey (53% response rate).


RESULTS
Sixteen percent of patients reported having experienced an error in their care, and 11% were currently very concerned about errors. Patients perceived the risk of four detailed errors as rather low, whereas the mean rating of potential harm from error was substantial. Relative to other errors, patients seem to underestimate the harm associated with drug overdosing. Seventy-seven percent of responders agreed that patients can help to prevent errors. Although patients perceived staff as being committed to providing safe care, ratings related to patient involvement in safety were considerably lower. More than one quarter of patients disagreed that staff instructed them to watch for and report errors. Patients engaged in safety behaviors, particularly in those behaviors that are compatible with traditional patient-provider relations. Risk of error perceptions, affirmative attitudes toward patient preventability, and error experience were positively linked to safety-related behaviors, whereas higher levels of global trust in staff safety practices were inconsistently associated with lower frequency of engagement in safety strategies.


CONCLUSIONS
Chemotherapy safety is a considerable concern for patients. Many patients are prepared to be involved in error prevention. The results highlight areas for improvement in communication and cooperation for safety between patients and providers.
Schwappach
David L B
DL
Swiss Patient Safety Foundation, Asylstr 77, 8032 Zürich, Switzerland. schwappach@patientensicherheit.ch
Wernli
Martin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004333:Drug Administration Routes; D064420:Drug-Related Side Effects and Adverse Reactions / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000523:psychology*; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology; D010342:Patient Acceptance of Health Care; D055815:Young Adult
D000970:Antineoplastic Agents