Preventing Errors in the Home Care of Children with Cancer

Background: In our study of outpatient cancer care, we found pediatric medication errors were more common and more likely to occur at home than adult errors. Since our CRN pilot proposal last year, we have made several gains in our research agenda including developing a theoretical framework, publishing our home visit methods, and developing strategies to assess reliability and validity.

Objectives: 1) To investigate the validity and reliability of our home visit methods in measuring home medication errors in pediatric oncology; 2) To describe the prevalence of and characterize the types of home medication errors among children with cancer at two CRN sites; and 3) To conduct qualitative focus groups using a purposive sample of parents and healthcare providers of children with cancer to propose interventions to prevent home medication errors.

Methods: We will conduct 30 home visits to families of children with cancer on chemotherapy treated at UMass Memorial Medical Center and 30 at Kaiser Permanente Georgia. We developed a home visit method which includes four components: (1) observation of medication administration, (2) medication review, (3) in-depth parent interviews, and (4) physician review of possible errors- with methods to validate findings at each step. These proposed home visits will lead to our identifying the worst – most prevalent, most dangerous – errors and learning where things are going wrong. In 15 pilot visits to families of children with cancer we found 56 errors. Parent/provider focus groups will then use a modified Failure Modes and Effects Analysis to propose possible interventions to prevent home pediatric oncology errors.

Conclusions: The proposed two center study will characterize home errors in children with cancer and propose interventions to prevent these errors. At the completion of this study, we will be prepared to perform a randomized multicenter evaluation of these interventions within the CRN.

<< Back to the list of CRN projects