Reducing dispensing errors in Swedish pharmacies: the impact of a barrier in the computer system

Nordén-Hägg, Annika; Andersson, Kristin; Sporrong, Sofia Kälvemark; Ring, Lena; Kettis, Åsa

doi:10.1136/qshc.2008.031823

Cited by 5 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Errors are the result of the situation and context in which the dispensation occurs, and they include exchange of products, dosage, or quantities, as well as flaws in the instructions for the correct use of the medicines. Nórden-Hägg et al 18 advocate that dispensation in conditions that disperse the professional’s attention (clutter, noise, crosstalk), in work under pressure (excess time or demand for work, queues) and in restricted spaces (small and poorly organized environments, without structure for individual dialogues) lead to the occurrence of dispensing errors and risks to users and professionals.…”

Section: Discussionmentioning

confidence: 99%

Medicine dispensing service in primary health care of SUS

et al. 2017

View full text Add to dashboard Cite

OBJECTIVE To characterize the medicine dispensing services in the primary health care network in Brazil and in its different regions, aiming to promote the access and rational use of medicines.METHODS This is a cross-sectional, quantitative study with data obtained from the Pesquisa Nacional sobre Acesso, Utilização e Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), 2015. Observation visits were carried out in 1,175 dispensing units, and interviews were held with 1,139 professionals responsible for the dispensation of medicines in the dispensing units and 495 municipal coordinators of pharmaceutical services.RESULTS More than half (53%) of the units presented a space smaller than 10 m2 for dispensing of medicines; 23.8% had bars or barriers between users and dispenser; 41.7% had computerized system; and 23.7% had counters for individual care. Among those responsible for dispensation, 87.4% said they always or repeatedly inform users how to use the medicines, and 18.1% reported developing some type of clinical activity. Isolated pharmacies presented a more developed physical and personal structure than those belonging to health units, but we found no significant differences regarding the information provided and the development of clinical activities.CONCLUSIONS There are major differences in the organization models of dispensation between cities, with regional differences regarding the physical structure and professionals involved. The centralization of medicine dispensing in pharmacies separated from the health services is associated with better structural and professional conditions, as in the dispensing units of the South, Southeast, and Midwest regions. However, the development of dispensation as health service does not prevail in any pharmacy or region of the Country yet.

show abstract

Section: Discussionmentioning

confidence: 99%

Medicine dispensing service in primary health care of SUS

et al. 2017

View full text Add to dashboard Cite

show abstract

“…[41] It is increasingly advocated to incorporate patient preferences in clinical guidelines and healthcare policy decisions. [41,42] In the frequentist approach of sample size estimation, aspects of patient preferences can only be included to the extent that this is reflected in the main therapeutic outcome. Therefore, only if a patient reported outcome (for example generic quality of life) is the main therapeutic outcome measure, patient preferences are involved.…”

Section: Discussionmentioning

confidence: 99%

Sample Size Estimation for Non-Inferiority Trials: Frequentist Approach versus Decision Theory Approach

et al. 2015

View full text Add to dashboard Cite

BackgroundNon-inferiority trials are performed when the main therapeutic effect of the new therapy is expected to be not unacceptably worse than that of the standard therapy, and the new therapy is expected to have advantages over the standard therapy in costs or other (health) consequences. These advantages however are not included in the classic frequentist approach of sample size calculation for non-inferiority trials. In contrast, the decision theory approach of sample size calculation does include these factors. The objective of this study is to compare the conceptual and practical aspects of the frequentist approach and decision theory approach of sample size calculation for non-inferiority trials, thereby demonstrating that the decision theory approach is more appropriate for sample size calculation of non-inferiority trials.MethodsThe frequentist approach and decision theory approach of sample size calculation for non-inferiority trials are compared and applied to a case of a non-inferiority trial on individually tailored duration of elastic compression stocking therapy compared to two years elastic compression stocking therapy for the prevention of post thrombotic syndrome after deep vein thrombosis.ResultsThe two approaches differ substantially in conceptual background, analytical approach, and input requirements. The sample size calculated according to the frequentist approach yielded 788 patients, using a power of 80% and a one-sided significance level of 5%. The decision theory approach indicated that the optimal sample size was 500 patients, with a net value of €92 million.ConclusionsThis study demonstrates and explains the differences between the classic frequentist approach and the decision theory approach of sample size calculation for non-inferiority trials. We argue that the decision theory approach of sample size estimation is most suitable for sample size calculation of non-inferiority trials.

show abstract

“…These reports were, at the time of the study, submitted through a national, web-based error reporting system and kept at the headquarters of the National Corporation of Pharmacies. In December 2007, 14.99 dispensing errors per 100,000 dispensed prescription items were reported in the Swedish community pharmacies [25]. …”

Section: Methodsmentioning

confidence: 99%

Exploring the relationship between safety culture and reported dispensing errors in a large sample of Swedish community pharmacies

Nordén-Hägg

Sporrong

Lindblad

2012

BMC Pharmacol Toxicol

View full text Add to dashboard Cite

BackgroundThe potential for unsafe acts to result in harm to patients is constant risks to be managed in any health care delivery system including pharmacies. The number of reported errors is influenced by a various elements including safety culture. The aim of this study is to investigate a possible relationship between reported dispensing errors and safety culture, taking into account demographic and pharmacy variables, in Swedish community pharmacies.MethodsA cross-sectional study was performed, encompassing 546 (62.8%) of the 870 Swedish community pharmacies. All staff in the pharmacies on December 1st, 2007 were included in the study. To assess safety culture domains in the pharmacies, the Safety Attitudes Questionnaire (SAQ) was used. Numbers of dispensed prescription items as well as dispensing errors for each pharmacy across the first half year of 2008 were summarised. Intercorrelations among a number of variables including SAQ survey domains, general properties of the pharmacy, demographic characteristics, and dispensing errors were calculated. A negative binomial regression model was used to further examine the relationship between the variables and dispensing errors.ResultsThe first analysis demonstrated a number of significant correlations between reported dispensing errors and the variables examined. Negative correlations were found with SAQ domains Teamwork Climate, Safety Climate, Job Satisfaction as well as mean age and response rates. Positive relationships were demonstrated with Stress Recognition (SAQ), number of employees, educational diversity, birth country diversity, education country diversity and number of dispensed prescription items. Variables displaying a significant relationship to errors in this analysis were included in the regression analysis. When controlling for demographic variables, only Stress Recognition, mean age, educational diversity and number of dispensed prescription items and employees, were still associated with dispensing errors.ConclusionThis study replicated previous work linking safety to errors, but went one step further and controlled for a variety of variables. Controlling rendered the relationship between Safety Climate and dispensing insignificant, while the relationship to Stress Recognition remained significant. Variables such as age and education country diversity were found also to correlate with reporting behaviour. Further studies on the demographic variables might generate interesting results.

show abstract

Reducing dispensing errors in Swedish pharmacies: the impact of a barrier in the computer system

Abstract: The intervention was associated with a decrease in the number of reports on drugs dispensed with the wrong strength, but also had a decreasing effect on errors caused by registration failure and on the dispensing errors in total as well.

Cited by 5 publications

References 24 publications

Medicine dispensing service in primary health care of SUS

Medicine dispensing service in primary health care of SUS

Sample Size Estimation for Non-Inferiority Trials: Frequentist Approach versus Decision Theory Approach

Exploring the relationship between safety culture and reported dispensing errors in a large sample of Swedish community pharmacies

Contact Info

Product

Resources

About