Source avec lien : Journal of Oncology Pharmacy Practice, , 5/13/2019. 10.1177/1078155219845432
Les unités de préparation de chimiothérapie font face à des pics d’activité entraînant des charges de travail élevées et un stress accru. La présente étude a évalué l’impact des surcharges de travail sur la sécurité et la précision des préparations manuelles. Les auteurs notent que, bien que les techniciens en pharmacie et les pharmaciens aient pu augmenter la vitesse de production sans affecter la précision de la concentration moyenne dans des conditions stressantes, les erreurs de probabilité étaient plus grandes. Ces résultats devraient encourager des mesures visant à répartir la charge de travail au cours de la journée afin d’éviter les pics d’activité.
Abstract
Purpose
Chemotherapy preparation units face peaks in activity leading to high workloads and increased stress. The present study evaluated the impact of work overloads on the safety and accuracy of manual preparations.
Method
Simulating overwork, operators were asked to produce increasing numbers of syringes (8, 16, and 24), with markers (phenylephrine or lidocaine), within 1 h, in an isolator, under aseptic conditions. Results were analyzed using qualitative and quantitative criteria. Concentration deviations of < 5%, 5%–10%, 10%–30%, and >30% from the expected concentration were considered as accurate, weakly accurate, inaccurate, and wrong concentrations, respectively.
Results
Twenty-one pharmacy technicians and pharmacists carried out 63 preparation sessions (n = 1007 syringes). A statistically significant decrease in the manufacturing time for one syringe was observed when workload increased (p < 0.0001). Thirty-nine preparation errors were recorded: 30 wrong concentrations (deviation > 30%), 6 mislabeling, 2 wrong diluents, and 1 wrong drug. There was no statistically significant difference in the mean concentration accuracy of final preparations across the three workloads. The overall error rate increased with the number of preparations made in 1 h: 1.8% for 8 preparations, 2.7% for 16 preparations, and 5.4% for 24 preparations (p < 0.05).
Conclusion
Although pharmacy technicians and pharmacists were able to increase production speeds with no effect on mean concentration accuracy under stressful conditions, there were greater probability errors being made. These results should encourage actions to spread workloads out over the day to avoid peaks in activity.