Errors dispensing

Bond CA, Raehl CL. 2001. Pharmacists assessment of dispensing errors Risk factors, practice sites, professional functions and satisfaction. Pharmacotherapy 21 614. 

How might poor human resources management in pharmacies cause (a) job stress and burnout, (b) medication dispensing errors, and (c) pharmacist shortages ... 

To commit no dispensing errors that result in an untoward event during the next 6 months Poor ... 

SIG (prescription instructions), and RxNorm (standard name, dose, and form availability) were not considered ready for implementation because of numerous approaches used in these three areas across health information technology. Electronic prescribing is not required under MMA, but plans are to have it available should providers choose to use it. As standards are developed, the adoption of e-prescribing is expected to improve patient safety by reducing prescribing and dispensing errors (Agency for Healthcare Research Quality, 2007). 

Riskprevention/mModijication. Pharmacy managers may not be able to eliminate a risk, but they can take steps to minimize the likelihood of its occurrence. All pharmacies take steps to avoid medication dispensing errors. This commonly involves the development of policies and procedures to prevent errors and improve patient safety (see Chapters 7 and 30). 

Civil liability (tort law) Stuart Johnson, R.Ph., is manager of Johnson s Apothecary, a community pharmacy. When he arrived at the pharmacy today, there was a frantic voice-mail message left for him in the middle of the night while the pharmacy was closed. It seems that a staff pharmacist, Dave, made a dispensing error yesterday, and Suzie Jones, a 3-year-old child, was taken unconscious by ambulance to the local community hospital emergency room at 2 00 a.m. Suzie and her family had just moved to town about 2 weeks ago, and yesterday was their first visit to Johnson s Apothecary. 

An important safety enhancement for preventing dispensing errors is the development of a system of redundant checks from the time a prescription order first is written in the physician s office or on the nursing unit to receipt in the pharmacy and through dispensing and administration. Such a system is suggested in this... 

Poon EG, Cina JL, Churchill W, et al. 2006. Medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the pharmacy. Ann Intern Med 145 426. 

Catalysts are commonly used to control the pouring and gel times of polyurethane systems. As catalysts are used in small quantities, the addition must be carried out very carefully otherwise, very erratic results may be obtained. Catalysts may be made into a concentrated solution with an inert carrier such as a plasticizer. This reduces a potential dispensing error. They also may be added to a liquid chain extender. 

For example, soon after the new arthritis drug Celebrex entered the market, the FDA received 53 reports of dispensing errors that occurred when it was mistaken for the antiseizure drug Cerebyx or the antidepressant drug Celexa. Other commonly... 

In a dispensing error a 14-year-old boy was given olanzapine 80 mg/day, eight times the recommended dose in adults (263). 

Pharmacists are most cognizant of avoiding dispensing errors. Dispensing errors can be traced to a number of system failure points, including com-... 

Similarly, although some states restrict electronic transmission of prescriptions, it is clear that this type of communication of prescriptions is increasing. Medication dispensing errors can be reduced with electronic prescription transmission. Several states have developed or are in the process of developing guidelines to ensure proper handling of electronic prescriptions. 

Flynn EA, Barker KN, Gibson JT, Pearson RE, Berger BA, Smith LA. Impact of interruptions and distractions on dispensing errors in an ambulatory care pharmacy. Am J Health Syst Pharm 1999 56 1319-25. 

The safety of levetiracetam has been assessed in 24 children with uncontrolled partial-onset seizures in an open study (16). The most commonly reported adverse events were headache (33%), infection (33%), anorexia (25%), and somnolence (25%). The adverse events profile of levetiracetam was similar to that seen in adults. Owing to a dispensing error, one patient received an accidental overdose of 71 mg/kg/day, rather than 40 mg/kg/day, during the last 4 weeks of the evaluable phase of the study. No iU effects were reported or observed on examination or laboratory testing, and the patient completed the trial. 

Lobel HO, Coyne PE, Rosenthal PJ. Drug overdoses with antimalarial agents prescribing and dispensing errors. JAMA 1998 280(17) 1483. 

Schwartz E, Regev-Yochay G. Primaquine as prophylaxis for malaria for nonimmune travelers A comparison with mefloquine and doxycycline. Clin Infect Dis I999 29(6) 1502-6. Lobel HO, Coyne PE, Rosenthal PJ. Drug overdoses with antimalarial agents prescribing and dispensing errors. JAMA 1998 280(17) 1483. 

OBJECTIVES Prevent the occurrence of dispensing errors Maintain a high level of professional service to patients... 

Allan, E. L., Barker, K. N., Malloy, M. J., Heller, W. M. (1995). Dispensing errors and counseling in community practice. American Pharmacy, NS35,... 

Abbreviations can cause dispensing errors. A prescription intending every-other-day dosing (qod) may be miswritten as od by the physician for other-day dosing the pharmacist wUl interpret od as the abbreviation of the Latin for right eye. Once-daily dosing at bedtime (qhs) may be misinterpreted as qhr for every hour. The use of slash marks ( ) to separate names and doses... 

FIGURE A—1 The prescription. The prescription must be carefully prepared to identify the patient and the medication to be dispensed, as well as the manner in which the drug is to be administered. Accuracy and legibility are essential. Use of abbreviations, particularly Latin, is discouraged, as it leads to dispensing errors. Inclusion of the purpose of the medication in the subscription (e.g., control of blood pressure") can prevent errors in dispensing. For example, the use of losartan for the treatment of hypertension may require 100 mg/day (1.4 mg/kg per day), whereas treat-... 

All prescriptions should be written in ink this practice is compulsory for schedule 11 prescriptions under the Controlled Substances Act of 1970, as erasures on a prescription easily can lead to dispensing errors or diversion of controlled substances. 

AE, administration error ED, emergency department ME, medication error NICU, neonatal intensive care unit PCICU, paediatric cardiac intensive care unit PICU, paediatric intensive care unit PE, prescribing error PCW, paediatric cardiac ward DE, dispensing error. 

Peterson, G.M., Wu, M.S.H. andBetgin, J.K. 1999. Pharmacists attitudes towards dispensing errors Their causes and prevention. Journal of Clinical Pharmacy and Therapeutics, 24, 57-71. 

Poon, E. G., et al.. Medication Dispensing Errors and Potential Adverse Drug Events Before and After Implementing Bar Code Technology in the Pharmacy, Annals of Internal Medicine, Vol. 145,2006, pp. 426-434. 

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