- Daniel Kelly (Cardiff, United Kingdom)
Patient safety and healthcare quality (ID 616)
- Ciara Kirke (Dublin, Ireland)
Error reporting in cancer care (ID 618)
- Oili Papinaho (Oulu, Finland)
Being safe - Feeling safe: The importance of supporting carers - Barriers/ enablers (ID 620)
- Rebecca Verity (London, United Kingdom)
CN31 - Adverse events in oncology and haemato-oncology inpatients of Swiss hospitals: A descriptive study (ID 3950)
- Anne Gerber (Lausanne, Switzerland)
Abstract
Background
The occurrence rate of adverse events (AEs) in hospitalised cancer patients in Switzerland remains unknown. The Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT) is among the most used methods to identify AEs. However, the GTT lacks oncology-specific triggers. Therefore, we developed a GTT-based Swiss Oncology Trigger Tool (SOTT), which included two modified GTT modules (“Cares” and “Medication”) and a new “Oncology” module. Objective We applied the SOTT to describe the occurrence rate, nature, level of harm and preventability of AEs reported in health records of four Swiss inpatient oncology and haemato-oncology units.
Methods
We reviewed records of discharged patients over a 6-week period using the method recommended by the IHI for the GTT. To identify documented AEs, two nurse reviewers analysed records using the SOTT. Identified AEs were subsequently validated by physician reviewers, and those occurring during hospitalisation were classified regarding the incurred level of harm and their preventability.
Results
We reviewed 224 records, 150 for oncology and 74 for haemato-oncology. Ninety-four of them (42%) contained at least one AE. In total we identified 169 AEs 100 for oncology and 69 haemato-oncology. Overall, we calculated a rate of 76 AEs/100 admissions and 108 AEs/1000 patients-days. “Pain related to care” was the most frequent AE reported (n = 29), followed by “Constipation” (n = 17) and “Anaemia” (n = 9). Most AEs were categorized as having caused temporary harm, either requiring an intervention (n = 98) or prolonging the hospital stay (n = 25). Two required an intervention to sustain the patient’s life. Exactly 78/125 (61%) were considered non-preventable, 28/125 (22%) preventable and 19/125(15%) undetermined.
Conclusions
This is the first Swiss study to identify and categorise AEs in the oncology setting. The application of the SOTT showed a relatively high rate of harm related to care, but only 22% were considered as preventable. The description of AEs with the SOTT might be an opportunity to prioritize the development of novel interventions to avoid or limit the impact of AEs on cancer patients’ lives.
Legal entity responsible for the study
Manuela Eicher.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
CN32 - Safe administration of 5-fluorouracil with elastomeric pumps (ID 1883)
- Paul Sessink (Bohus-Björkö, Sweden)
Abstract
Background
Occupational exposure to cytotoxic drugs may cause adverse health effects. Nurses administrating cytotoxic drugs may face exposure risk when disconnecting infusion lines especially with elastomeric pumps as they are frequently disconnected during an infusion period of several days.
Methods
Potential contamination when disconnecting infusion lines of elastomeric pumps containing 5-fluorouracil was monitored. Three different connections were evaluated: 1) Luer Lock Male + Female 2) Luer Lock Male + Needleless connector (BD-Q-Syte®) 3) QimoMale® + QimoFemale® The evaluation was performed on a tissue mimicking patient’s arm. During disconnection, potential leakage will contaminate the tissue and the gloves used for personal protection. After disconnection, both end parts of the connection were cleaned with a wipe. The wipe, the pair of gloves, and the tissue were analysed separately for contamination with 5-fluorouracil usingLC-MSMS. Ten elastomeric pumps (Baxter-Folfusor®) were used for each type of connection. All disconnections were performed by one trained nurse after about 40 hrs of infusion.
Results
Contamination with 5-fluorouracil is found for all thirty pumps but the level of contamination differs a lot. The highest contamination is measured for the wipes (end parts). Contamination on the tissues and on the gloves is substantially lower. For the wipes, a significant difference is found between the three connections (p = 0.007). Median contamination is 50% lower for connection 3 (76 μg; p = 0.013) compared to connection 1 (152 μg) and 44% lower compared to connection 2 (135 μg; p = 0.031). There is no difference in contamination between the connections 1 and 2.
Conclusions
1) The lowest contamination with 5-fluorouracil is found for connection 3. 2) Contamination with 5-fluorouracil does not differ between the connections 1 and 2. 3) The presence of 5-fluorouracil on the gloves supports the need of wearing gloves to protect nurses from exposure by skin contact during administration of cytotoxic drugs.
Legal entity responsible for the study
Exposure Control Sweden AB.
Funding
Vygon SA, Ecouen, France.
Disclosure
All authors have declared no conflicts of interest.