Relationships between Ambient Sounds and the Accuracy of Pharmacists' Prescription-Filling Performance

Abstract

Associations between ambient sounds and accuracy of pharmacists' prescription-filling performance in a pharmacy was studied. Pharmacists were videotaped as they filled prescriptions each workday for 23 days. Each filled prescription was inspected by the investigator. Deviations from the physician's written order were considered errors. Videotape analysis was used to detect unpredictable, predictable, uncontrollable, and controllable sounds. A within-subjects case control study design was employed to determine whether the frequency of ambient sounds was significantly different when prescriptions with errors, compared with those without errors, were filled. Loudness, in terms of equivalent sound levels (Leq) for each half hour, was analyzed for a relationship to dispensing error rate. A mean dispensing error rate of 3.23% was found. Unpredictable sounds, controllable sounds, and noise had a significant effect on pharmacists which resulted in a decreased dispensing error rate. These results suggest that the quality of pharmacists' performance is not adversely affected by ambient sound. As equivalent sound levels increased, the error rate increased to a point, then decreased.

Measuring human-error probabilities in drug preparation: a pilot simulation study

“…The extent of variations in HEPs revealed by our results requires a move from traditional observational studies towards experimental research based on randomised controlled trials. In this regard, much remains to be done, although some task details [24][25][26][27] as well as a few performance-shaping factors are already under investigation [28][29][30]. For instance, the reliability of various tasks in relation to label design (e.g.…”

Incidence, type and causes of dispensing errors: a review of the literature

“…[39] Dispensing error rate Forty-five reviewed papers reported the dispensing error rate in community and/or hospital pharmacy (Tables 7 and 8). [14,15,17,19,21,[24][25][26][27][28]30,32], [3,[33][34][35]38,39,[43][44][45][46][47][49][50][51][52][53][54][55][56][57][59][60][61][62][63][64][65][66][67][68][69][70][71][72] However, only 18% (n = 8) of these papers clearly defined the calculation of dispensing-error rate. [15,28,…”

“…Flynn and colleagues [59,61] investigated the impact of ambient sounds and interruptions on unprevented dispensing incidents in US hospital pharmacies. Pharmacy staff involved in dispensing were videotaped over a 23-day period and a study investigator performed final accuracy checks on the dispensed medication.…”

“…Details of unprevented dispensing incidents recorded by the investigators were compared with information on ambient noise, interruptions and distractions obtained by reviewing the videotapes. [59,61] It was found that unpredictable audible stimuli, controllable audible stimuli and noise were statistically associated with a lower incidence of unprevented dispensing incidents. [59] In contrast, interruptions and distractions per half hour were both significantly associated with unprevented dispensing incidents (interruptions, F = 8.22, W r o n g p a t ie n t n a m e o n la b e l W r o n g q u a n t it y o n la b e l W r o n g w a r d /c o s t c e n t r e /p r e s c r ib e r o n la b e l Is s u e e r r o r O t h e r Figure 7 Most common types of unprevented dispensing incidents reported by US hospital pharmacies with manual [49,50,52,54,57,58,[63][64][65] and automated [57] dispensing systems.…”

“…[61] These studies had a number of limitations; notably, data on ambient sounds, interruptions and distractions were missed when videotapes were changed. [59,61] In addition, the authors acknowledge that the observers' accuracy at detecting unprevented dispensing incidents was not verified. [59,61] Consequently, these studies may underestimate the occurrence of sounds, interruptions, distractions and unprevented dispensing incidents but provide the only objective measurement of these factors on unprevented dispensing incident rate.…”