[Detectig errors in chemotherapy prescription]. / Detección de errores en la prescripción de quimioterapia.

OBJECTIVE: To analyse errors detected in the prescription of cytostatic drugs. MATERIAL AND METHODS: Prospective study (February 1st to April 15th, 2002). All medical orders containing cytostatic agents were checked and 13 variables were studied: identification, anthropometric data, diagnosis, protocol, number of cycles, cytostatic drug, length of treatment, dose, route of administration, volume of infusion and/or final concentration, infusion time, diluent, and doctor's signature. Several possible errors were identified for each variable. Information on whether it was the first cycle, prescribing service, and prescription format was also recorded. RESULTS: In all, 618 medical orders were reviewed for a total of 1178 lines of cytostatic agents and 2,171 doses. The possible number of errors was 12.101 and the total number of errors actually found was 2,706 (22,03%). Not all these errors had the same impact on patients. Errors by omission were 2,340 (87,77%). Those which nursing staff found difficult to check and/or administer stood at 281 (10,54%). Potentially serious errors numbered 60 (2.06%): wrong body area > 10%: 5; wrong body area 5-10%: 2; erroneus protocol: 2; incorrect volume: 16; wrong dosage: 23 (difference < 25%: 5; difference 10-25%: 14; difference < 10%: 4). Reductions indicated but not implemented: 9; Inappropiate diluent: 3. There were no incorrect or omitted medications. CONCLUSION: The description of such errors and their uantification is a useful method of quality asurance in order to establish appropiate corrective measures. The most common error was the omission of information and therefore this issue, along with the development of computerised prescriptions, should be addressed.

[Randomized double-blind study of treatment of croup with adrenaline and/or dexamethasone in children]. / Estudio randomizado doble ciego del tratamiento del crup en la infancia con adrenalina y/o dexametasona.

We present the results of a study designed to verify the efficacy of nebulized L-Adrenaline and/or dexamethasone given intramuscularly (IM) in the treatment of croup during childhood. Sixty-six children, hospitalized for croup during the period between october 1989 and september 1990, entered the study. They received the ordinary treatment with oxygen-therapy and fluid-therapy and were randomly assigned, in a double-blind fashion, into one of four treatment groups: Group 1: Nebulized L-Adrenaline and placebo (IM). Group 2: Nebulized saline and placebo (IM). Group 3: Nebulized saline and dexamethasone (IM). Group 4: Nebulized L-Adrenaline and dexamethasone (IM). The clinical evaluation was based on a scoring system assessing the inspiratory stridor, croupy cough, retractions and cyanosis. An analysis of variance was performed on the evolution of the score for two factors (Adrenaline and dexamethasone) to verify that there was no interaction between them. Subsequently, a one-factor analysis of variance was performed on the four treatment groups. We conclude that nebulized Adrenalin is more beneficial than saline in the clinical evolution of croup (p < 0.05). However, we did not find a statistically significant improvement in the group treated with dexamethasone when compared with the group treated with the placebo IM injection.