Following the fluorouracil incident in 2006, and the release of the associated incident report, CAPCA’s Systemic Therapy Safety Committee identified a need for more research into the safety issues with ambulatory IV chemotherapy in Canada. An exploratory, pan-Canadian, interdisciplinary research project was initiated to:

  • Identify current practices for ordering, preparing, labeling, verifying & administering ambulatory IV chemotherapy in Canada
  • Identify additional sources of risk in a wide variety of care environments
  • Recommend strategies to reduce risks

The project was completed in Autumn of 2010 by researchers from the Health Technology Safety Research Team and Healthcare Human Factors at the University Health Network, with guidance from the Systemic Therapy Safety Committee . The final report, accompanying Guidelines for Developing Ambulatory Chemotherapy Preprinted Orders, and editable preprinted order templates for three chemotherapy regimens (CHOP-R, FOLFIRI, and Gemcitabine and Cisplatin for bladder cancer), are available to download.

Recommendations are grouped into four themes:

  1. Elastomeric ambulatory infusion pumps (AIPs) and access devices
  2. Orders and labels
  3. Pharmacy practices
  4. Additional issues

The research study provides vital information that will inform decisions about the care of individuals with cancer and the way cancer care delivery systems are designed. As an organization committed to high quality, safe patient care, CAPCA and its Board of Directors is committed to:

  • Supporting the generation of new knowledge to improve patient safety across the cancer system
  • Applying knowledge and innovation to improve the delivery of care
  • Monitoring the safe delivery of chemotherapy
  • Looking for and acting upon opportunities to enhance the safe care of individuals being treated for cancer
  • Working collaboratively on solutions that address provincial needs and opportunities
  • Ongoing discussion about the research recommendations
  • Learning from implementation efforts in a variety of jurisdictions and environments
  • Creating dialogue with professional organizations such as CAMO, CAPhO, and CANO

Documents to download

Improving the Safety of IV Ambulatory Chemotherapy in Canada

Guidelines for Developing Ambulatory Chemotherapy Preprinted Orders

Pre-Printed Order Templates:

Elastomeric Pump Documentation: