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9 How to overcome medication errors
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Abstracts and Learning Outcomes / European Journal of Oncology Nursing 18S1 (2014) S1–S22
at a time when the majority of their symptom management is prescriptive. A growing body of literature concerning the non-pharmacological management of breathlessness and it has established the key role that nurses have in teaching and supporting these patients. Although non-pharmacological approaches appear to be beneficial to the majority of patients with lung cancer experiencing breathlessness, such interventions may be less suitable for patients as functional status becomes progressively worse. Conclusion: The essence of non-pharmacological interventions is both holistic and heuristic. Non-pharmacological interventions to improve breathing efficiency that have been reported to be effective include IMT (inspirational muscle training), pursed lip breathing, diaphragmatic breathing, positioning and pacing techniques. Psychosocial interventions seeking to reduce anxiety and distress can also improve the management of breathlessness although further studies are needed. No conflict of interest.
Parallel Session: Management of Therapy Related Skin Reactions 6 Dealing with radiodermatitis K. Oren1 . 1 American Hospital, Radiation Oncology, Istanbul, Turkey Radiodermatitis is the most common side effect of radiotherapy. Ninety percent of the patients receiving radiotherapy experience some degree of skin reactions. The severity may be mild for the most of the patients, but nearly a 40% percent experience more severe reactions including dry and moist desquamations. A number of therapy and patient related factors have effects on the severity of the skin reactions. Therefore, a radiotherapy nurse should assess with the best tools and expertise to identify high-risk patients and intervene with the best and evidence based approach. Prevention is usually not possible, but early intervention may have a great benefit for the patients. There are an increasing number of studies in this area, yet only some provide good and definitive data to decide on what products to use in order to prevent or alleviate radiodermatitis. ONS’s PEP and EONS’s euroPEP are good resources to refer for busy nurses in the clinical setting with limited time to review all of the literature. The two main responsibilities of radiotherapy nurses with regard to radiodermatitis is patient education. A standardized, comprehensive and evidence based education program may increase the quality of life of patients receiving radiotherapy. The education program must be tailored for each patient’s needs and risk according to nursing assessment. No conflict of interest. 7 Treatment strategies during targeted therapy C.B. Boers-Doets1,2 . 1 IMPAQTT Research & Consultancy, Clinical Oncology, Wormer, Netherlands; 2 Leiden University Medical Center, Department of Clinical Oncology, Leiden, Netherlands Introduction: Skin Reactions are the most common adverse events of targeted therapies like Epidermal Growth Factor Receptor (EGFR) inhibitors and multi-targeted Tyrosine Kinase Inhibitors (mTKI). They also occur during treatment with mammalian Target of Rapamycin (mTOR) inhibitors, BRAF inhibitors, and even in newer targeted therapies. The skin reactions are diverse, ranging from maculopapular and papulopustular rash, dry skin, fissures, to paronychia, granuloma, hand-foot skin reaction, and photosensitivity. Also this is not a complete listing, it addresses the most common skin reactions. Material and Method: In this lecture the above mentioned skin reactions will be primarily addressed. Since no appropriate
management of adverse events is possible without exploring the signs and symptoms of these side effects, these will be discussed first. The impact on the quality of life (QoL) and on current management options will be presented subsequently. Results and Discussion: When a structured assessment is performed, it appears to be easy to select appropriate management options based on the symptom profile. Conclusion: The professional is able to recognize signs and symptoms, and impact on QoL of selected skin reactions. Afterwards, he will also be able to select appropriate management options. Conflict of interest: Ownership: IMPAQTT Research & Consultancy. Advisory board: Amgen, Astra Zeneca, Bayer Pharmaceuticals, Boehringer Ingelheim, Eusa Pharma, GlaxoSmithKline, Merck Serono, Merck Sharp and Dohme, Nordic Pharma, Takeda, Novartis, Pfizer, and Roche. Board of directors: ISOO, LOOV, IMPAQTT Foundation. 8 Cutaneous reactions to chemotherapy and their management No abstract received. No conflict of interest information specified.
Parallel Session: Patient Safety 9 How to overcome medication errors L. Sharp1 . 1 Karolinska University Hospital, Department of Oncology, Stockholm, Sweden According to the WHO, approximately 10% of all patients are harmed by the health care system in some way. Many of these errors are related to medications. Cytotoxic agents are among the most frequent drugs involved in medication errors and these errors may have catastrophic consequences, due to high toxicity and narrow therapeutic index. Cancer patients are also extra vulnerable due to the seriousness of the disease, co morbidity and often old age. The chemotherapy process in complex and nurses, physicians and pharmacists often need to keep track of hundreds of different regimens, and adjusting them to each specific patient. Errors occurs during prescription, preparation, administration, monitoring and in the communication in-between. This calls for standardized and safe procedures to reduce the risk for unnecessary errors. Nurses have a key role to identify safety risks and to prevent medication errors. Preliminary data from a recent study at our Department shows that many cancer patients are unaware of the documented changes in their medication during hospital stays, one week after discharge. During this session, risk factors for medication errors will be discussed. The main focus will be on prevention and what nurses can do in their daily practice to reduce the risk of medication errors. With the growing number of oral cancer therapies, many patients can control their medications themselves. This means great benefits but also increased risk of non-adherence. Patient participation has been identified as one of the key components to avoid medication errors in cancer care. Different aspects of patient participation will also be covered. No conflict of interest. 10 Recognising and reducing the risk of chemotherapy extravasation No abstract received. No conflict of interest information specified.
Abstracts and Learning Outcomes / European Journal of Oncology Nursing 18S1 (2014) S1–S22
at a time when the majority of their symptom management is prescriptive. A growing body of literature concerning the non-pharmacological management of breathlessness and it has established the key role that nurses have in teaching and supporting these patients. Although non-pharmacological approaches appear to be beneficial to the majority of patients with lung cancer experiencing breathlessness, such interventions may be less suitable for patients as functional status becomes progressively worse. Conclusion: The essence of non-pharmacological interventions is both holistic and heuristic. Non-pharmacological interventions to improve breathing efficiency that have been reported to be effective include IMT (inspirational muscle training), pursed lip breathing, diaphragmatic breathing, positioning and pacing techniques. Psychosocial interventions seeking to reduce anxiety and distress can also improve the management of breathlessness although further studies are needed. No conflict of interest.
Parallel Session: Management of Therapy Related Skin Reactions 6 Dealing with radiodermatitis K. Oren1 . 1 American Hospital, Radiation Oncology, Istanbul, Turkey Radiodermatitis is the most common side effect of radiotherapy. Ninety percent of the patients receiving radiotherapy experience some degree of skin reactions. The severity may be mild for the most of the patients, but nearly a 40% percent experience more severe reactions including dry and moist desquamations. A number of therapy and patient related factors have effects on the severity of the skin reactions. Therefore, a radiotherapy nurse should assess with the best tools and expertise to identify high-risk patients and intervene with the best and evidence based approach. Prevention is usually not possible, but early intervention may have a great benefit for the patients. There are an increasing number of studies in this area, yet only some provide good and definitive data to decide on what products to use in order to prevent or alleviate radiodermatitis. ONS’s PEP and EONS’s euroPEP are good resources to refer for busy nurses in the clinical setting with limited time to review all of the literature. The two main responsibilities of radiotherapy nurses with regard to radiodermatitis is patient education. A standardized, comprehensive and evidence based education program may increase the quality of life of patients receiving radiotherapy. The education program must be tailored for each patient’s needs and risk according to nursing assessment. No conflict of interest. 7 Treatment strategies during targeted therapy C.B. Boers-Doets1,2 . 1 IMPAQTT Research & Consultancy, Clinical Oncology, Wormer, Netherlands; 2 Leiden University Medical Center, Department of Clinical Oncology, Leiden, Netherlands Introduction: Skin Reactions are the most common adverse events of targeted therapies like Epidermal Growth Factor Receptor (EGFR) inhibitors and multi-targeted Tyrosine Kinase Inhibitors (mTKI). They also occur during treatment with mammalian Target of Rapamycin (mTOR) inhibitors, BRAF inhibitors, and even in newer targeted therapies. The skin reactions are diverse, ranging from maculopapular and papulopustular rash, dry skin, fissures, to paronychia, granuloma, hand-foot skin reaction, and photosensitivity. Also this is not a complete listing, it addresses the most common skin reactions. Material and Method: In this lecture the above mentioned skin reactions will be primarily addressed. Since no appropriate
management of adverse events is possible without exploring the signs and symptoms of these side effects, these will be discussed first. The impact on the quality of life (QoL) and on current management options will be presented subsequently. Results and Discussion: When a structured assessment is performed, it appears to be easy to select appropriate management options based on the symptom profile. Conclusion: The professional is able to recognize signs and symptoms, and impact on QoL of selected skin reactions. Afterwards, he will also be able to select appropriate management options. Conflict of interest: Ownership: IMPAQTT Research & Consultancy. Advisory board: Amgen, Astra Zeneca, Bayer Pharmaceuticals, Boehringer Ingelheim, Eusa Pharma, GlaxoSmithKline, Merck Serono, Merck Sharp and Dohme, Nordic Pharma, Takeda, Novartis, Pfizer, and Roche. Board of directors: ISOO, LOOV, IMPAQTT Foundation. 8 Cutaneous reactions to chemotherapy and their management No abstract received. No conflict of interest information specified.
Parallel Session: Patient Safety 9 How to overcome medication errors L. Sharp1 . 1 Karolinska University Hospital, Department of Oncology, Stockholm, Sweden According to the WHO, approximately 10% of all patients are harmed by the health care system in some way. Many of these errors are related to medications. Cytotoxic agents are among the most frequent drugs involved in medication errors and these errors may have catastrophic consequences, due to high toxicity and narrow therapeutic index. Cancer patients are also extra vulnerable due to the seriousness of the disease, co morbidity and often old age. The chemotherapy process in complex and nurses, physicians and pharmacists often need to keep track of hundreds of different regimens, and adjusting them to each specific patient. Errors occurs during prescription, preparation, administration, monitoring and in the communication in-between. This calls for standardized and safe procedures to reduce the risk for unnecessary errors. Nurses have a key role to identify safety risks and to prevent medication errors. Preliminary data from a recent study at our Department shows that many cancer patients are unaware of the documented changes in their medication during hospital stays, one week after discharge. During this session, risk factors for medication errors will be discussed. The main focus will be on prevention and what nurses can do in their daily practice to reduce the risk of medication errors. With the growing number of oral cancer therapies, many patients can control their medications themselves. This means great benefits but also increased risk of non-adherence. Patient participation has been identified as one of the key components to avoid medication errors in cancer care. Different aspects of patient participation will also be covered. No conflict of interest. 10 Recognising and reducing the risk of chemotherapy extravasation No abstract received. No conflict of interest information specified.