[Show abstract][Hide abstract] ABSTRACT: To determine the rate and the primary types of medication dispensing errors detected by pharmacists during implementation of a unit dose drug dispensing system.
The central pharmacy at the Percy French military hospital (France).
The check of the unit dose medication cassettes was performed by pharmacists to identify dispensing errors before delivering to the care units. From April 2006 to December 2006, detected errors were corrected and recorded into seven categories: unauthorized drug, wrong dosage-form, improper dose, omission, wrong time, deteriorated drug, and wrong patient errors.
Dispensing error rate, calculated by dividing the total of detected errors by the total of filled and omitted doses; classification of recorded dispensing errors.
During the study, 9,719 unit dose medication cassettes were filled by pharmacy technicians. Pharmacists detected 706 errors for a total of 88,609 filled and omitted unit doses. An overall error rate of 0.80% was found. There were approximately 0.07 detected dispensing errors per medication cassette. The most common error types were improper dose errors (n = 265, 37.5%) and omission errors (n = 186, 26.3%). Many causes may probably explain the occurrence of dispensing errors, including communication failures, problems related to drug labeling or packaging, distractions, interruptions, heavy workload, and difficulties in reading handwriting prescriptions.
The results showed that a wide range of errors occurred during the dispensing process. A check performed after the initial medication selection is also necessary to detect and correct dispensing errors. In order to decrease the occurrence of dispensing errors, some practical measures have been implemented in the central pharmacy. But because some dispensing errors may remain undetected, there is a requirement to develop other strategies that reduce or eliminate these errors. The pharmacy staff is widely involved in this duty.
International Journal of Clinical Pharmacy 04/2009; 31(4):432-8. DOI:10.1007/s11096-009-9290-3 · 0.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Many dispensing errors occur in the hospital, and these can endanger patients. The purpose of this study was to assess the rate of dispensing errors by a unit dose drug dispensing system, to categorize the most frequent types of errors, and to evaluate their potential clinical significance.
A prospective study using a direct observation method to detect medication-dispensing errors was used. From March 2007 to April 2007, 'errors detected by pharmacists' and 'errors detected by nurses' were recorded under six categories: unauthorized drug, incorrect form of drug, improper dose, omission, incorrect time, and deteriorated drug errors. The potential clinical significance of the 'errors detected by nurses' was evaluated.
Among the 734 filled medication cassettes, 179 errors were detected corresponding to a total of 7249 correctly fulfilled and omitted unit doses. An overall error rate of 2.5% was found. Errors detected by pharmacists and nurses represented 155 (86.6%) and 24 (13.4%) of the 179 errors, respectively. The most frequent types of errors were improper dose (n = 57, 31.8%) and omission (n = 54, 30.2%). Nearly 45% of the 24 errors detected by nurses had the potential to cause a significant (n = 7, 29.2%) or serious (n = 4, 16.6%) adverse drug event.
Even if none of the errors reached the patients in this study, a 2.5% error rate indicates the need for improving the unit dose drug-dispensing system. Furthermore, it is almost certain that this study failed to detect some medication errors, further arguing for strategies to prevent their recurrence.
[Show abstract][Hide abstract] ABSTRACT: Many dispensing errors occur in hospital pharmacies and can harm patients if they are not intercepted. The aim of this study was to determine the incidence and the primary types of medication dispensing errors at a French military hospital.
The check of unit dose medication cassettes was performed by nurses. From February 2007 to April 2007, detected dispensing errors were systematically recorded and classified into 6 categories: unauthorized drug, wrong dosage-form, improper dose, omission, wrong time, and deteriorated drug errors. The overall error rate was calculated.
During the study, 5112 medication cassettes were checked. 106 dispensing errors have been detected by nurses for a total of 45,573 filled (n=45,518) and omitted (n=55) unit doses. An overall error rate of 0.23% was found. There were approximately 0.02 detected dispensing errors per medication cassette. The most common error types were omission errors (n=55, 51.88%) and improper dose errors (n=30, 28.30%).
The results of this study showed that a check performed by nurses after the dispensing process is necessary to detect the dispensing errors. Many causes may explain the occurrence of dispensing errors and must be corrected. Because some dispensing errors may remain undetected, there is a requirement to develop strategies in order to reduce or eliminate these errors, such as the implementation of a computerized prescribing system. The pharmacy staff is widely involved in this duty.
Journal de pharmacie de Belgique 10/2008; 63(3):73-7.
[Show abstract][Hide abstract] ABSTRACT: Non-small-cell lung cancer (NSCLC) is a frequent tumour with a bad prognosis and remains difficult to treat. In order to offer an optimal care to patients right after their diagnostic, an extensive coordination of currently available therapeutic means should be realized by establishing multidisciplinary meetings aiming for therapeutic decisions. Participation to these meetings would require the hospital pharmacist to have a basic knowledge in the field of pathology and of patient treatments. Surgery remains the optimal treatment but is only possible in twenty percent of NSCLC diagnoses. A treatment combining external radiotherapy with antitumoral chemotherapy is frequent for unresectable tumours. In most cases, antitumoral chemotherapy is composed of platinum-salt combinations and of two-drug-combination regimens or of single-agent chemotherapy without platinum compounds for the metastatic phases. Supporting care and a better usage of anticancer drugs allow their good employment. Innovative molecular therapies targeting the signalization of angiogenesis constitute the progress, that, even if modest, it increases the effectiveness of treatments and improves the patient’s quality of life.
Le Pharmacien Hospitalier 06/2008; 43(173):93–102. DOI:10.1016/S0768-9179(08)70006-3