title: Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs.
abstract: BACKGROUND
  In spite of increasing efforts to enhance patient safety, medication errors in hospitalised patients are still relatively common, but with potentially severe consequences. This study aimed to assess antineoplastic medication errors in both affected patients and intercepted cases in terms of frequency, severity for patients, and costs.
  
  
  METHODS
  A 1-year prospective study was conducted in order to identify the medication errors that occurred during chemotherapy treatment of cancer patients at a French university hospital. The severity and potential consequences of intercepted errors were independently assessed by two physicians. A cost analysis was performed using a simulation of potential hospital stays, with estimations based on the costs of diagnosis-related groups.
  
  
  RESULTS
  Among the 6, 607 antineoplastic prescriptions, 341 (5.2%) contained at least one error, corresponding to a total of 449 medication errors. However, most errors (n = 436) were intercepted before medication was administered to the patients. Prescription errors represented 91% of errors, followed by pharmaceutical (8%) and administration errors (1%). According to an independent estimation, 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage, while 2.6% would have compromised the vital prognosis of the patient, with four to eight deaths thus being avoided. Overall, 13 medication errors reached the patient without causing damage, although two patients required enhanced monitoring. If the intercepted errors had not been discovered, they would have resulted in 216 additional days of hospitalisation and cost an estimated annual total of 92,907€, comprising 69,248€ (74%) in hospital stays and 23,658€ (26%) in additional drugs.
  
  
  CONCLUSIONS
  Our findings point to the very small number of chemotherapy errors that actually reach patients, although problems in the chemotherapy ordering process are frequent, with the potential for being dangerous and costly.
authors: Hospices Civils de Lyon, Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, Pierre Bénite - Université Lyon 1, EMR UCBL/HCL 3738, Lyon, France.
authors: Florence
authors: F
authors: Ranchon
authors: Gilles
authors: G
authors: Salles
authors: Hans-Martin
authors: HM
authors: Späth
authors: Vérane
authors: V
authors: Schwiertz
authors: Nicolas
authors: N
authors: Vantard
authors: Stéphanie
authors: S
authors: Parat
authors: Florence
authors: F
authors: Broussais
authors: Benoît
authors: B
authors: You
authors: Sophie
authors: S
authors: Tartas
authors: Pierre Jean
authors: PJ
authors: Souquet
authors: Claude
authors: C
authors: Dussart
authors: Claire
authors: C
authors: Falandry
authors: Emilie
authors: E
authors: Henin
authors: Gilles
authors: G
authors: Freyer
authors: Catherine
authors: C
authors: Rioufol
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D005602:France; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008508:Medication Errors / Q000191:economics / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics; D055553:Prescription Drugs; D011446:Prospective Studies
chemical_list: D000970:Antineoplastic Agents; D055553:Prescription Drugs