Consumer safety when receiving cancer drug therapy


Receiving cancer treatment, including chemotherapy, can be a very frightening experience. It may feel as if you are placing your life completely in the hands of your doctors and nurses. In a very real sense you are, especially if you are unfamiliar with the medications you are receiving. To make you feel more secure, here are some safety tips that some of our nurses wrote for you.

For instance, did a nurse ever hand you a cup full of medications and say, "here are your morning medicines"? Are you "guilty" of accepting those medications without knowing their names? Have you ever looked up at your intravenous medication and see fluid in the container but you do not know what it is or how long it should infuse? These scenarios are true for some patients because they have complete trust in their health care providers, which allows them to feel safe. However, as important as trust is, blind trust is not enough to safeguard you against a medication error.

It is very important for all patients to realize that nurses and doctors are human and despite the many check systems in place it's still possible for an error to happen.

One mistake by your health care provider could mean a tragic result for you. Although extremely rare, there have been tragic medication errors involving cancer patients. Naturally, you want to protect yourself or your loved one from the possibility of such a situation. Many doctors and nurses realize that their best ally in preventing a medication error tragedy is you! So here are some safety tips for avoiding chemotherapy medication errors.

The most important safety tip is to learn about the type of cancer you have and the treatment choices you have. Most patients probably have done this in one way or another when first diagnosed. However, educating yourself should not end with only knowing about your disease and treatment options. It must be more far-reaching than that. Chemotherapy is the use of medicines to treat cancer. There are a number of medicines that can be used alone or in combination to treat cancer. Various factors about you and the type of cancer you have help the doctor determine which chemotherapy drug or drugs will be used to treat your specific cancer.

Education about your treatment is important. You need to listen carefully and write down the name and dose of every medication that your doctor outlines in your treatment plan. Most cancer nurses will give you educational pamphlets about each medication you will receive. They will review the treatment plan and go over some key side effects that you may experience. They will also give you instructions on what to do if these side effects should occur. Some may also provide you with an outline of your treatment schedule. It is important for you to maintain complete and up-to-date records of all the medication names and doses (including brand and generic name, such as Tylenol/acetaminophen) that you receive. Knowing what you got, when you got it, and why you got it will help in managing your care. Be sure that you read and understand this material. Become familiar with the drug names and their possible side effects. If you don't understand, contact your nurse and ask for an additional explanation.

All of this becomes especially important when you go to your treatment center or into the hospital. It helps you assure that you are receiving the specific treatment plan prescribed for you. Also, you will be in a better position to recognize side effects when they do occur, in order to call them to your doctor's attention. In this way, a bad reaction can be caught earlier and treated sooner to prevent more serious harm.

Remember, sometimes medicines can appear different in size, shape, and color. This could be because a generic brand is used. On the other hand, it could be that the medication name on your chart was misread or a verbal communication was misheard. Therefore, anytime you are unsure, it is best to have the nurse confirm the medication BEFORE taking it. An example of this is highlighted in the following case.

A mother prevented an error when she questioned the brown color of a medication already in a syringe. The nurse told the mother it was her child's Imferon, which is a form of iron. The mother asked the nurse to check further. When she did, the nurse found that the medication was supposed to be interferon, an important drug used to treat her child's leukemia. The mother's action prevented her child from receiving the wrong medication. So, if you have a question about a medication, do not take it until your questions are answered to your satisfaction. Ask your nurse to identify all your medications by name and dose before you take them. Always be ready to serve as part of the check system by knowing what you are supposed to get.

Another safety tip is to make sure the nurse confirms your identity before giving you any medicines. In the hospital you will be given an identification band to wear on your wrist. Make sure it has your correct information on it. Also, make sure the nurse checks it before any treatments are given. If your wrist band has not been checked, it is important for you to tell the nurse your full name. You can even ask the nurse to check your wrist band. Many treatment facilities now use bar-code scanning when medications are given. The nurse can scan your wrist band and the medicine to make sure that it is the right medicine for you.

In a doctor's office or treatment center, they may not use identification bands. It is important for you to tell the nurse your full name and not go by what you think you heard when a name was called. Also, ask the nurse to match your address and/or date of birth with the address on her records. Healthcare providers need to use two patient identifiers before providing any treatments. Surprisingly, two patients with the same surname might be present in the office at the same time. Or, sometimes, in the rush to get the treatment started, it is even possible for people not to realize that the wrong patient's name has been called.

There are many different ways chemotherapy treatments are given. Sometimes, extra medicines or extra fluid need to be given to prevent side effects. You should be aware of all the things you need during your treatment. This way you will notice and question if things are different. For example, if you get medication to prevent nausea before the treatment, you can question the nurse if the medicine is not given. Any changes in your treatment should be explained to you. You also need to know how long it will take to give you the chemotherapy. It may be fifteen minutes, hours or even days.

Also, know how often the chemotherapy is to be given. Some courses of chemotherapy are given daily over a four or five day period while other therapies are just given once. Some courses of therapy are repeated every three or four weeks while others are not. Some chemotherapy must be given manually (injected IV from a syringe by a doctor or nurse) while in other cases it is given as a constant infusion, controlled by an electronic pump. Again, be sure to question anything that doesn't seem right. Then be sure to get a plausible explanation for the change from both the doctor and the nurse!

Record all chemotherapy that you receive. For example, you may get your first chemotherapy treatment in the hospital. Then, later treatments may be given to you in an outpatient clinic. It is important to know what you got and when you got it, so you can tell the healthcare providers in the clinic. They should be able to receive information from the hospital, but it can make things a little easier to confirm. One way to keep track of the treatments you received is to ask for a business or appointment card, noting this information. Keep the card with you so you have the information available when you go to your next appointment.

Remember, as a patient, you are part of the check system that helps to assure medication safety. Be assertive. Ask your health care providers questions about your chemotherapy and expect thorough answers. If you do not completely understand the response, keep asking until you do. Take notes because it is difficult to remember the names, doses, and course of therapy of these medications. People who are shy or feel intimidated by the doctors and nurses should ask a family member or friend to be their advocate. The advocate can ask the questions and go to the doctor's office or hospital with you. Then make sure the advocate is with you for your treatment so they can be involved in the check system. Note the following example:

One advocate prevented a critical medication error from happening. A doctor inadvertently switched how many times the chemotherapy and anti-nausea medicines were to be given. Chemotherapy that was supposed to be given only once was ordered for three doses. The anti-nausea medicine was ordered only to be given once instead of three times. When the nurse went to give a second dose of chemotherapy in the same day, the advocate spoke up. The advocate stated that the patient had already received a dose of chemotherapy that day. So, the nurse rechecked the patient’s chart and noticed the error. Whether you are a cancer patient or are an advocate for a cancer patient, following these tips will help prevent medication errors.

Remember, you need to learn as much as you can about the chemotherapy treatments. And simply speak up if there is any question in your mind. You are the final check in the system!

Created on January 19, 2009

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