Nature of dispensing errors in selected hospitals providing free healthcare: A multi-center study in Sri Lanka

Abstract

Background Dispensing errors may result in patient harm. Dispensing errors are preventable if we knew its nature, but only very little information is available on these errors that occur in limited resourced settings where healthcare is provided free of charge. Therefore, the purpose of this study was to determine the types and prevalence of dispensing errors in selected hospitals in Sri Lanka. Methods A prospective, cross sectional and multi-centered study (in one tertiary care and two secondary care hospitals) was conducted among 420 patients attending medical, surgical, diabetes and pediatric clinics of study hospitals, proportioned according to population size, and selected through a systematic random sampling. A prescription audit was conducted. Dispensing errors were categorized as content, labelling, documentation, concomitant, and other errors based on definitions developed in-house. The total number of dispensing errors identified was used as the denominator for calculating percentages. Results A total of 420 prescriptions (1849 medicines) were analyzed (Hospital-01, 248 prescriptions with 1010 medicines; Hospital-02, 84 prescriptions with 400 medicines; Hospital-03, 88 prescriptions with 439 medicines), where 16,689 dispensing errors were detected. However, most frequent were labelling errors (63.1%). There were 4.9% content errors, 21% concomitant errors, 10.6% documentation errors, and 0.4% of other errors. No omissions or deteriorated medicines were detected. Conclusions Dispensing errors happen in Sri Lankan hospitals that operate with limited resources and provide free healthcare to citizens. However, most were labeling errors with little chance of immediate harm. Content errors were minimal. More emphasis on error-proofing the dispensing process could improve medication safety in these hospitals.

A Novel Method for Reducing Dispensing Error in Hospital Pharmacy

“…Studies on dispensing errors have become hot topics in the eld of pharmacy services eld [2][3][4][5][6]. A systematic review and meta-analysis of community pharmacy error rates in the USA showed that dispensing error rates ranged from 0.00003%(43/1420091) to 55%(55/100) [7] between 1993 and 2015.…”