RESUMEN
The Canadian oncology community was devastated by the news in August 2006 that a patient had died from an overdose of fluorouracil. Where we once thought our checks and balances ensured patient safety, we now knew they were not enough. Practice immediately began to change around the country. However, the incident report highlighted that there was much we still didn't know about safety issues in intravenous ambulatory chemotherapy safety in Canada. In response, an interdisciplinary, pan-Canadian team launched an 18-month exploratory study, resulting in a report identifying several safety issues and associated recommendations. This paper summarizes the key insights we have gathered for Canadian oncology nurses in being part of this study: that we need courage to come forward and disclose safety concerns; we should collaborate to come up with safety improvements that work for everyone; and we should strive to simplify our work at the sharp end by reducing complexity upstream and throughout the system.
Asunto(s)
Antineoplásicos/administración & dosificación , Errores Médicos/prevención & control , Sistemas de Medicación/organización & administración , Neoplasias/tratamiento farmacológico , Gestión de Riesgos/organización & administración , Alberta , Antineoplásicos/envenenamiento , Participación de la Comunidad , Sobredosis de Droga , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/envenenamiento , Humanos , Bombas de Infusión , Infusiones Intravenosas , Investigación en Evaluación de Enfermería , Medición de RiesgoRESUMEN
Before developing interventions for stomatitis, nurses require a simple, valid and reliable approach to staging severity. The eight-item WCCNR(R) was previously validated for chemotherapy-induced stomatitis. In this study, the validity and reliability of the WCCNR(R), a shorter three-item tool for staging stomatitis caused by chemotherapy, radiotherapy, or both, was assessed. Pairs of data collectors evaluated 207 patients from 10 Canadian cancer centres. The WCCNR(R) correlated well with the MacDibbs Mouth Assessment (r = 0.44, p = 0.0002 to r = 0.54, p < 0.0001), a standardized tool for staging radiotherapy-induced stomatitis. Agreement between data collectors at five sites was acceptable (kappa = 0.75); three additional sites were close to this target. Findings indicate that the WCCNR is a valid and reasonably reliable tool for staging stomatitis due to cancer therapy.
