Assessing the Impact of Chemotherapy Education on Practice Change for Error Prevention: A Program Evaluation
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Date
2017-05
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The Ohio State University
Abstract
Antineoplastic regimens are complex, with inherent toxicity and narrow therapeutic indices that may result in life-threatening patient harm should an error occur. Chemotherapy nurses need to have specialized knowledge and competence in error prevention and recognition. Additionally, workplace culture, leadership, and policies and procedures must provide support for safe chemotherapy care. This project assessed how completion of a comprehensive chemotherapy course may impact individual and organizational error prevention strategies. Fifteen error preventive nursing behaviors were identified in practice guidelines and standards. These critical behaviors and the organizational processes to support them were addressed in a descriptive, cross-sectional survey that utilized retrospective, self-reported data from 334 registered nurses who completed the course between October 2015 and March 2016. Course content impacted practice with up to 27% of respondents reporting either increased awareness of the need to perform a specific behavior, or that they had initiated change in a specific behavior. Overall, the two nursing behaviors impacted most related to verifying drug-specific dose limits and using generic drug names. Nurses holding professional oncology certification reported a lesser impact on nine of the practice behaviors than non-certified nurses. Organizationally, at least 30% started discussions with colleagues related to policies and procedures. More than 60% encountered at least one barrier to individual and organizational change. This program evaluation was an initial step in exploring knowledge application to practice through behaviors that promote chemotherapy error prevention. Recommendations for practice are: 1) provide comprehensive chemotherapy education for oncology nurses, 2) integrate practice guidelines and standards, 3) assess practice change needs related to critical nursing behaviors, 4) implement organizational processes to support practice change, and 5) prioritize a culture of safety.
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Keywords
patient safety, chemotherapy errors, program evaluation, nursing education