The influence of ‘Tall Man’ lettering on errors of visual perception in the recognition of written drug names

Abstract

Visual errors in the perception of written drug names can reflect orthographic similarity amongst certain names. Drug names are typically printed in lowercase text. 'Tall Man' lettering, the capitalisation of the portions that differ amongst orthographically similar drug names, is employed in the field of medication labelling and prescribing to reduce medication errors by highlighting the area most likely to prevent confusion. The influence of textual format on visual drug name perception was tested amongst healthcare professionals (n = 133) using the Reicher-Wheeler task. Relative to lowercase text, Tall Man lettering improved accuracy in drug name perception. However, an equivalent improvement in accuracy was obtained using entirely uppercase text. Thus, character size may be a key determinant of perceptual accuracy for Tall Man lettering. Specific considerations for the manner in which Tall Man lettering might be best formatted and implemented in practice to reduce medication errors are discussed. STATEMENT OF RELEVANCE: Tall Man lettering aims to prevent medication errors by reducing visual confusions amongst orthographically similar drug names. It was found that, compared to lowercase text, Tall Man lettering improved accuracy in drug name perception. Character size appeared to be a key determinant of perceptual accuracy for Tall Man lettering.

Tallman lettering as a strategy for differentiation in look-alike, sound-alike drug names: The role of familiarity in differentiating drug doppelgangers

“…A number of studies have used sensitive measures with simple displays for the purpose of studying the effect of Tallman lettering on the recognition of drug names (Darker et al, 2011;Schell, 2009;Filik et al, 2010). For instance, Darker et al (Darker et al, 2011) presented a single drug name at very low visual contrast.…”

“…For instance, Darker et al (Darker et al, 2011) presented a single drug name at very low visual contrast. Participants selected the name in a two-alternative, forced-choice task that included both the original and the confusable names.…”

“…Many of these techniques include format manipulations of drug names on labels employing the use of: italics, bold type, underlining differing fonts and styles of typography (Darker et al, 2011;Gabriele, 2006). Tallman lettering constitutes one such approach.…”

Perception of Patient Safety, Quality Improvement and Nursing Errors Issues among Undergraduate Nursing Students in Faculty of Nursing, Alexandria University, Egypt

“…[ [1][2][3][4][5][6][7][8][9][10] Measuring Safety Darker and colleagues (2011) [ 11 ] developed a framework for measuring patient safety in two categories. The first is valid rate-based measures that are readily available to answer the questions -How often do we harm patients?‖ and -How often do we provide the interventions the patient should receive?‖ (Darker, et al, 2011(Darker, et al, , p. 1603. The second category includes indicators that are essential to patient safety but cannot be measured as valid rates to answer the questions -How do we know we learned from defects?‖ and -How well have we created a culture of safety?‖ (Darker et al, 2011(Darker et al, , p. 1603).…”

The Interventional Pathologist

“…The list should be communicated to potential customers. The use of ''tall-man'' lettering for a portion of the name is widely acceptable in pharmacy practice [2][3][4][5][6] and may reduce confusion between medications with look-alike and sound-alike names, such as cycloSERINE and cycloSPOR-INE. In addition, to minimize the inaccuracy of test results, likely because of the highly unstable nature of cycloSERINE, the specimen collection, handling, storage, and transportation must be closely followed.…”