Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users

Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users

Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. To evaluate the experiences of pharmacists and pharmacy technicians with alerts for dru...

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Bibliographic Details
Published in:PloS one Vol. 13; no. 5; p. e0197469
Main Authors: Campmans, Zizi, van Rhijn, Arianne, Dull, René M, Santen-Reestman, Jacqueline, Taxis, Katja, Borgsteede, Sander D
Format: Journal Article
Language:English
Published: United States Public Library of Science 29-05-2018
Public Library of Science (PLoS)
Subjects:
Analysis
Confusion
Decision making
Decision support systems
Dispensing
Drug stores
Drug therapy
Epidemiology
Fatigue
Information systems
Internet
Medical errors
Medication errors
Medicine and Health Sciences
Methods
Names
Patient safety
People and Places
Pharmacists
Practice
Prescription drugs
Prevention
Registration
Research and Analysis Methods
Response rates
Risk reduction
Strength
Technicians
Australia
United States > US
Netherlands
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Summary:Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. 'Alert fatigue' was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue.
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Competing Interests: RMD is employed at SAL pharmacy Schuytgraaf. The subject being studied in this manuscript is subject to the clinical decision support used in the pharmacy. SAL pharmacy Schuytgraaf has a scientific, non-commercial interest in the subject being studied. Involvement of SAL pharmacy Schuytgraaf does not alter our adherence to PLOS ONE policies on sharing data and materials.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0197469