BackgroundDispensing errors are common in hospital pharmacies. Investigating dispensing errors is important for identifying the factors involved and developing strategies to reduce their occurrence.ObjectivesTo review published studies exploring the incidence and types of dispensing errors in hospital pharmacies and factors contributing to these errors.MethodsElectronic databases including PubMed, Scopus, Ovid, and Web of Science were searched for articles published between January 2000 and January 2015. Inclusion criteria were: studies published in English, and studies investigating type, incidence and factors contributing to dispensing errors in hospital pharmacies. One researcher searched for all relevant published articles, screened all titles and abstracts, and obtained complete articles. A second researcher assessed the titles, abstracts, and complete articles to verify the reliability of the selected articles.Key findingsFifteen studies met the inclusion criteria all of which were conducted in just four countries. Reviewing incident reports and direct observation were the main methods used to investigate dispensing errors. Dispensing error rates varied between countries (0.015%–33.5%) depending on the dispensing system, research method, and classification of dispensing error types. The most frequent dispensing errors reported were dispensing the wrong medicine, dispensing the wrong drug strength, and dispensing the wrong dosage form. The most common factors associated with dispensing errors were: high workload, low staffing, mix-up of look-alike/ sound-alike drugs, lack of knowledge/experience, distractions/interruptions, and communication problems within the dispensary team.ConclusionStudies relating to dispensing errors in hospital pharmacies are few in number and have been conducted in just four countries. The majority of these studies focused on the investigation of dispensing error types with no mention of contributing factors or strategies for reducing dispensing errors. Others studies are thus needed to investigate dispensing errors in hospital pharmacies, and a combined approach is recommended to investigate contributing factors associated with dispensing errors and explore strategies for reducing these errors.

Background: As people age, they become increasingly vulnerable to the untoward effects of medicines due to changes in body systems. These may result in medicines related problems (MRPs) and consequent decline or deterioration in health. Aim: To identify MRPs, indicators of deterioration associated with these MRPs, and preventative interventions from the literature. Design and Setting: Systematic review of primary studies on MRPs originating in Primary Care in older people. Methods: Relevant studies published between 2001 and April 2018 were obtained from Medline (via PubMed), CINAHL, Embase, Psych Info, PASCAL, Scopus, Cochrane Library, Science Direct, and Zetoc. Falls, delirium, pressure ulcer, hospitalization, use of health services and death were agreed indicators of deterioration. The methodological quality of included studies was assessed using the Down and Black tool. Results: There were 1858 articles retrieved from the data bases. Out of these, 21 full text articles met inclusion criteria for the review. MRPs identified were medication error, potentially inappropriate medicines, adverse drug reaction and non-adherence. These were associated with indicators of deterioration. Interventions that involved doctors, pharmacists and patients in planning and implementation yielded benefits in halting MRPs. Conclusion: This Systematic review summarizes MRPs and associated indicators of deterioration. Appropriate interventions appeared to be effective against certain MRPs and their consequences. Further studies to explore deterioration presented in this systematic review is imperative.

Introduction Antibiotics are widely administered for various indications, leading to increased antimicrobial resistance (AMR) in acute care hospitals. Since the onset of the COVID-19 pandemic, Antimicrobial Stewardship (AMS) effective strategies should be used to maintain the rational use of antibiotics and decrease the threat of Antimicrobial Resistance (AMR). Aim This systematic literature review aims to investigate the AMS intervention Before-the-pandemic (BP) and During-the-pandemic (DP) from the literature. Design and setting Systematic literature review of primary studies on AMS implementation in acute care settings. Methods Relevant studies published between 2000 and March 2021 were obtained from Medline (via PubMed), OVID, CINAHL, International Pharmaceutical Abstracts, Psych Info, Scopus, Web of Science, Cochrane Library, OpenGrey, and Google Scholar, using a comprehensive list of search terms. Public Health England (PHE) toolkit was agreed upon as a gold standard for the AMS implementation. Results There were 8763 articles retrieved from the databases. Out of these, 13 full-text articles met the inclusion criteria for the review. The AMS implementation was identified in the included studies into AMS strategies (Core strategies & Supplemental strategies), and AMS measures BP and DP. Conclusion This Systematic literature review summarises AMS implementation strategies and measures all over the previous 20 years of research. There are many lessons learnt from COVID-19 pandemic. The proper selection of the AMS implementation strategies and measures appeared to be effective in maintaining the appropriate use of antibiotics and decreasing the AMR threat, especially during the COVID-19 pandemic. Further studies are required to provide empirical data to evaluate the AMS implementation and identify which of these strategies and measures were effective BP and DP. In order to be prepared for any emergency/crisis or future pandemics.

Introduction: Antibiotics are widely administered for various indications, leading to increased antimicrobial resistance (AMR) in acute care hospitals. Since the onset of the COVID-19 pandemic, Antimicrobial Stewardship (AMS) effective strategies should be used to maintain the rational use of antibiotics and decrease the threat of Antimicrobial Resistance (AMR). Aim: To investigate the AMS intervention Pre-pandemic (PP) and During-the-pandemic (DP) from the literature. Design and Setting: Systematic review of primary studies on AMS implementation in acute care settings. Methods: Relevant studies published between 2000 and March 2021 were obtained from Medline (via PubMed), Embase, OVID, CINAHL, International Pharmaceutical Abstracts, Psych Info, Scopus, Web of Science, Cochrane Library, OpenGrey, and Google Scholar, using a comprehensive list of search terms. Public Health England (PHE) toolkit was agreed as a gold standard for the AMS intervention strategies. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) Programme. Results: There were 8763 articles retrieved from the databases. Out of these, 16 full-text articles met the inclusion criteria for the review. The AMS implementation was identified as AMS strategies, which include core and supplemental strategies and AMS measures PP and DP. Conclusion: This Systematic review summarises AMS implementation strategies and measures. Appropriate interventions appeared to be effective in maintaining the proper use of antibiotics and decreasing the AMR threat, especially DP. Further studies to investigate AMS implementation presented in this systematic review are imperative.

BackgroundDispensing medication is a chain of multiple stages, and any error during the dispensing process may cause high potential risk for the patient. Few research studies have investigated the nature and the contributory factors that are associated with dispensing errors in hospital pharmacies.PurposeTo determine the nature and severity of unprevented dispensing errors reported in the hospital pharmacy at Luton and Dunstable Hospital in the UK; and to explore the pharmacy staff’s perceptions of contributory factors to dispensing errors and strategies to reduce these errors.Material and methodsA mixed method approach was used and encompassed two phases. Phase I: a retrospective review of dispensing error reports for an 18 month period from 1 January 2012 to 30 June 2013 was conducted. An assessment of the potential clinical significance of the dispensing errors was undertaken. Data were analysed using descriptive statistics. Phase II: self-administered qualitative questionnaires were distributed to the dispensary team at the hospital. Content analysis using NVivo software was undertaken.Results766 medication error reports were documented and 49 (6.4%) reports were related to dispensary incidents. The most frequently reported dispensing errors were: dispensing the wrong medicine (n = 9, 18.4%), labelling the wrong strength (n = 8, 16.3%) and dispensing the wrong strength (n = 7, 14.3%). The majority of the dispensing errors had minor or moderate potential to harm patients. Look-alike/sound-alike medicines, high workload, lack of staff experience, fatigue and loss of concentration during work, hurrying through tasks and distraction in the dispensary were the most common contributory factors. Furthermore, ambiguity of the prescriptions was also reported as a contributory factor in the hospital.ConclusionDecreasing distractions in the pharmacy are needed to enhance patient safety. Furthermore, monitoring and reporting errors, and educating the dispensary team about these errors are also needed. An e-prescribing system may help to improve dispensing efficiency and safety. The findings of this study re-emphasise the fact that dispensing errors are widespread in hospital pharmacy. Therefore, efficient interventions need to be implemented to mitigate these errors.References and/or AcknowledgementsMany thanks to the Saudi Ministry of Health for the scholarship and funding my studyNo conflict of interest.