MORE LIGHTS, LESS NOISE
COULD CUT PHARMACY ERRORS
(1) High noise levels in the pharmacy, including radio
and television sounds, were also associated with a
higher percentage of errors...
(2) Pharmacy errors cause 7,000 deaths per year (and rising)
(3) Lead researcher recommends "go to a pharmacy that's
somewhat quiet."
NEW YORK (Reuters Health) - The millions of medication dispensing errors
made each year in community-based pharmacies in the US could be greatly
reduced by increasing lighting, having more employees on hand and making
other subtle changes, new study findings suggest.
"Dispensing errors are a nationwide problem, occurring at a rate of 2
errors for every 100 prescriptions filled," according to study author Dr.
Elizabeth A. Flynn of Auburn University in Auburn, Alabama and her
colleagues. "This translates to over 60 million errors on 3 billion
prescriptions filled each year in the US."
While these errors are only a small percentage of the billions of correctly
filled prescriptions, there is "a pretty high chance that people would be
at some risk," Flynn told Reuters Health. "We're trying to get up to
100%
accuracy."
Flynn and her colleagues investigated medication dispensing errors in an
observational study of 50 chain, health-system and independent
community-based pharmacies in Illinois, Texas, California, Pennsylvania,
Washington and Florida.
Altogether, they inspected 5,784 prescriptions and found 91 errors, or an
error rate of 1.57%, they report. They also identified 74 near-errors.
Flynn presented her findings on Wednesday during the Human Factors and
Ergonomics Society's 46th annual meeting in Baltimore, Maryland.
Most errors occurred with the filling of new prescriptions and nearly 60%
were labeling errors, in which the wrong information or instructions were
listed on the medication label.
For that reason, Flynn recommends that consumers know what they are being
prescribed before they leave the doctor's or nurse's office, "so they'll
be
able to recognize the problem."
High noise levels in the pharmacy, including radio and television sounds,
were also associated with a higher percentage of errors, study findings
indicate. Further, errors in content, such as when the packaging contained
the wrong drug, or the wrong drug quantity, were more common when the
lighting was dim in the prescription filling and inspection areas, the
report indicates.
Many errors in content were also identified in pharmacies that used only
manual inspection of various medications, rather than a bar code scanning
system, which was used in eight pharmacies. In fact, pharmacies that relied
totally on manual inspection systems identified only one-quarter of errors
in content, while bar code scanning systems identified 62% of such errors.
Still, "bar code check systems don't prevent all errors," Flynn
said.
"Technology is helpful, but it's not the whole answer."
The number of people on staff in each pharmacy also contributed to the
percentage of errors that were made and the percentage of near-errors that
were detected, study findings indicate.
For example, 6 in 10 errors in content and one third of labeling errors
occurred when two or fewer employees, including pharmacists and
technicians, were available. Also, while nearly half of the near-errors
were detected when only two or fewer employees were available,
approximately two-thirds of near-errors were detected when four employees
were available.
The availability of patient bins to store prescriptions for individual
patients, the pharmacy's drug storage--with adequate space, rather than
with drugs packed tightly on shelves, and the drug arrangement by alphabet
also seemed to contribute to fewer errors in content and increased
detection of near-errors, the report indicates.
In light of the findings, Flynn recommends that consumers get their
prescriptions filled at a well-lit pharmacy and that they "go to a
pharmacy
that's somewhat quiet."
Overall, however, the low percentage of errors "might help alleviate some
fears," particularly about chain pharmacies, she said. Perhaps the
situation is "not as bad as maybe they think it is."
Flynn's co-authors, also of Auburn University, were Nathan T. Dorris, Grady
T. Holman. Brian J. Carnahan and Kenneth N. Barker.