Table 3 Possible failures of the treatment prescription and administration process, ranked by RPN in each phase with sum of criticality indices

Defining treatment plan

26

Errors or failures in the entry of preset treatment plans

10 (5–10)

Failure or delay in updating preset treatment patterns

8 (4–10)

Failure to notify treatment providers of updates or new preset treatment patterns available

8 (4–10)

Nominal therapy prescription

64

Failure to prescribe premedication tailored to the type of patient (e.g., allergy history)

24 (12–36)

Failure to prescribe or incorrect prescription of ancillary/supportive therapy (antiemetics, PPIs, etc.)

16 (16–20)

Prescribing physician's error in filling out required forms

12 (10–20)

Failure to evaluate results of blood tests mandatory for the administration of the treatment

8 (2–8)

Therapy prescription impossible due to IT malfunctions (e.g., computer-based medical records)

4 (4–4)

Confirming therapy (first administration)

12

Incorrect/incomplete evaluation of results of blood tests and/or other tests required for the established treatment plan

12 (10–12)

Confirming therapy (from second administration onwards)

40

Incorrect/incomplete evaluation of results of blood tests and/or other tests required for the established treatment plan

20 (10–32)

Incomplete evaluation of toxicities encountered following administration of chemotherapy, failure to modify treatment dosage, failure to administer ancillary/supportive therapy (steroids, antiemetics, PPIs, etc.)

20 (20–42)

Validating therapy

30

Error in validating previously prescribed and confirmed therapy

30 (10–32)

Patient waiting for treatment to be administered

28

Overcrowded waiting areas

16 (2–24)

Patient fainting

12 (10–18)

Transportation of drugs

30

Damage to preparations in transit

30 (10–40)

Checking therapy prior to administration

60

Error in identifying the right patient

30 (10–40)

Error in identifying the therapy to administer to the patient

30 (10–50)

Administering therapy

46

Delay in drug administration

16 (10–24)

Damage due to chemotherapy extravasation

10 (8–16)

Adverse reactions due to noncompliance with administration schedules

8 (8–10)

Adverse reactions due to errors in the sequence of administration of infusion bags, or to failure to administer ancillary therapies

6 (6–9)

Failure to act or delay in response to pump alarm or patient’s call

6 (6–6)