ASHP Guidelines on Preventing Medication Errors with Antineoplastic Agents

The purpose of these guidelines is to assist practitioners in improving their antineoplastic medication-use system and error-prevention programs. They supplement ASHP’s Guidelines on Preventing Medication Errors in Hospitals and address error prevention within diverse health care settings.’ Further, these guidelines provide updated general guidance to include a standard definition of a “medication error” and applicable aspects of recommendations from the National Coordinating Council on Medication Error Reporting and Prevention (NCCMERP). NCCMERP’s definition of a medication error is “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care provider, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use.” Comprehensive recommendations are provided in these guidelines for preventing errors with antineoplastic agents in health care organizations, with an emphasis on hospitals and ambulatory care clinics that offer direct pharmacy services. Nevertheless, it is strongly recommended that the guidance also be adopted by other settings, including physician office practices and home care. The recommendations cover known procedural, technical, and behavioral elements that could systematically reduce a health care organization’s vulnerabilities to errors. However, strict adherence to good practice recommendations is not sufficient. Since the complexities of antineoplastic therapy afford unlimited opportunities for system failures, continuous diligence to verify accuracy is critical by all persons responsible for medication-use functions. These guidelines focus on the medication-use responsibilities shared by and unique to specific professional health care disciplines, progressing from general to specific applications. The structure of the guidelines, by necessity, includes the repetition of some material, repeated and enhanced in specific sections and recommendations for different health care disciplines. The guidelines contain the following major sections: