IHI.org - A resource from the Institute for Healthcare Improvement
Header Image






Reduce ADEs Involving Chemotherapy:
Set Dose Limits for Chemotherapy Drugs

Due their high potency and risk of toxicity, doses of chemotherapy drugs must be exact. An unintentional overdose can result in severe harm, or even death, for the patient. A maximum allowable dose for each chemotherapeutic agent should be set so that a prescriber or person entering an order cannot accidentally select a dose outside the safe range. Each individual dose may appear to be within acceptable safety limits, but the cumulative dose must be considered as well. Remember to set the maximum dose limits not just for each individual dose, but for the amount to be given in 24 hours, during the course of therapy, or over the patient’s total lifetime.


Tips
  • Set maximum dose limits for all of the following: single dose, daily dose, course dose, and lifetime dose.
  • Use pre-printed orders sheets that incorporate the dose limits.
  • Restrict chemotherapy orders to a limited group of prescribers approved by the organization.
  • Require consultation and approval from another approved prescriber if a request is made for a dose outside the limits.
  • Don’t accept any verbal orders for chemotherapy drugs.