Table 1 .

Incidents presented according to the main defence (as in figure 1) breached

Defence	Number of reports
Administration only in designated centres	0
Only those on local register can prescribe, dispense, issue, check or administer intrathecal (IT) chemotherapy	0
IT chemotherapy on separate prescription with accompanying checklist and audit trail	1
Intravenous (IV) and IT chemotherapy separated in time	15
1. Administered at separate times—IV then IT	6
2. Signature to confirm all IV chemotherapy for that day given, before IT released to the doctor who will administer it	9
IV and IT chemotherapy separated in location	7
1. Separate storage in pharmacy and ward areas, with IT doses in a dedicated locked fridge	5
2. Separate storage in pharmacy and ward areas, with IT doses in a dedicated locked fridge	5
3. Separate transport of IT in distinctive container	1
4. Administration in separate clinical areas	1
IV and IT chemotherapy differentiated in appearance	6
1. IV vinca alkaloids for adults and adolescents prepared in minibags, not syringes	1
2. Labelling of medication with route of administration printed in bold ‘for intrathecal use only’ and ‘for intravenous use only’	5
Under normal circumstances, administered during working hours only	0
Administration checks	0
Other	6
TOTAL	35

Bold numbers represent main categories; italic numbers represent sub-categories of these.