Exploring opiate errors in the specialist cancer and palliative care setting: perceptions of key stakeholders (#232)
In the specialist cancer and palliative care setting, high risk medications such as opiates are frequently prescribed to manage cancer related pain. After falls, medication errors are the second most frequent incident reported in acute care settings in Australia, with morphine and oxycodone hydrochloride administration errors reported most frequently.1 While, it is known that these errors occur in the acute care setting little is known about the incidence and types of opiate errors seen specifically in specialist cancer and/or palliative care settings.
To gain insights from key stakeholders into the types of opiate errors perceived to be occuring in the cancer and specialist palliative care settings.
A series of key stakeholder consultations were undertaken with lead clinicians from cancer care (inpatient/ambulatory), palliative care (inpatient/community) and pharmacy, from three public hospital sites in NSW. A structured group consultation process was used to identify the perceived scope, cause and types of opiate errors that they perceive to commonly occur in their practice settings. Detailed field notes were taken by a scribe (NH) and feedback to participants at the end of each group allowing for clarification and confirmation. Thematic content analysis was used to identify emerging themes from this data.
Nine types of opiate errors were perceived by stakeholders to occur in cancer and palliative care settings. These errors were classified as: i) conversion and dose equivalence errors; ii) administration errors; iii) nomenclature errors; iv) transcription errors; v) prescribing errors; vi) breakthrough analgesia and titration errors; vii) knowledge errors; viii) accountability errors; and ix) human error.
This process has revealed a wide range of opiate errors related to various provider and system factors. The next stage of this investigation is to verify and quantify the themes identified by key stakeholders, and to develop an implementation intervention to reduce opiate errors within the specialist cancer and palliative care settings.