Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Health Review |
Texto Completo: | https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/32069 |
Resumo: | Objective: In this study, the drug dispensing system of a tertiary care center was analysed, with the purpose of identifying the occurrence of dispensing errors, their types, causes, and the role of double checking in prevention. The main factors that contribute for the errors and the recommendations to avoid them have been evaluated from the perspective of the professionals involved in the dispensation process. Methods: 1,077 prescriptions were assessed in a 6-month period. The errors were recorded and corrected before the medication left the pharmacy. Each pharmaceutical unit dispensed was considered as a possibility of error. The results were analyze through descriptive statistics (average, median, standard deviation, coefficient of variation, and frequencies). In the second step of the research, the opinion of the professionals directly involved with dispensing about causes and consequences of the errors was assessed through a questionnaire with open and closed questions to explore the factors and causes of errors. Results: A 4.5% rate of dispensing errors inside the pharmacy was observed , during the double-check process. The rate observed when the medicines arrived at the admission units was of 0.37%. The most frequent class of errors in dispensing was drug omission (62.9%), followed by dose added errors (11.7%); incorrect time (10.2%); incorrect drug (9.2%), and changed dosage form (6.4%). We found a direct relationship between the number of dispensed items during a shift and the number of dispensing errors (?=0,844). The schedule for team shifts influenced the error rate (p=0,016). Conclusion: Knowing the dispensing error profile is crucial for promoting behaviour changes and to define adequated error barriers. |
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Brazilian Journal of Health Review |
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Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causasmedication errorsdispensing errorshospital pharmacy serviceBrazilObjective: In this study, the drug dispensing system of a tertiary care center was analysed, with the purpose of identifying the occurrence of dispensing errors, their types, causes, and the role of double checking in prevention. The main factors that contribute for the errors and the recommendations to avoid them have been evaluated from the perspective of the professionals involved in the dispensation process. Methods: 1,077 prescriptions were assessed in a 6-month period. The errors were recorded and corrected before the medication left the pharmacy. Each pharmaceutical unit dispensed was considered as a possibility of error. The results were analyze through descriptive statistics (average, median, standard deviation, coefficient of variation, and frequencies). In the second step of the research, the opinion of the professionals directly involved with dispensing about causes and consequences of the errors was assessed through a questionnaire with open and closed questions to explore the factors and causes of errors. Results: A 4.5% rate of dispensing errors inside the pharmacy was observed , during the double-check process. The rate observed when the medicines arrived at the admission units was of 0.37%. The most frequent class of errors in dispensing was drug omission (62.9%), followed by dose added errors (11.7%); incorrect time (10.2%); incorrect drug (9.2%), and changed dosage form (6.4%). We found a direct relationship between the number of dispensed items during a shift and the number of dispensing errors (?=0,844). The schedule for team shifts influenced the error rate (p=0,016). Conclusion: Knowing the dispensing error profile is crucial for promoting behaviour changes and to define adequated error barriers.Brazilian Journals Publicações de Periódicos e Editora Ltda.2021-06-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/3206910.34119/bjhrv4n3-351Brazilian Journal of Health Review; Vol. 4 No. 3 (2021); 14181-14194Brazilian Journal of Health Review; v. 4 n. 3 (2021); 14181-141942595-6825reponame:Brazilian Journal of Health Reviewinstname:Federação das Indústrias do Estado do Paraná (FIEP)instacron:BJRHenghttps://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/32069/pdfCopyright (c) 2021 Brazilian Journal of Health Reviewinfo:eu-repo/semantics/openAccessde Moura, Luciana LimaCunha, Rafael GarciaFonseca, Ana Beatriz Monteirode Brito, Monique Araújode Castilho, Selma Rodrigues2021-07-01T20:07:16Zoai:ojs2.ojs.brazilianjournals.com.br:article/32069Revistahttp://www.brazilianjournals.com/index.php/BJHR/indexPRIhttps://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/oai|| brazilianjhr@gmail.com2595-68252595-6825opendoar:2021-07-01T20:07:16Brazilian Journal of Health Review - Federação das Indústrias do Estado do Paraná (FIEP)false |
dc.title.none.fl_str_mv |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
title |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
spellingShingle |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas de Moura, Luciana Lima medication errors dispensing errors hospital pharmacy service Brazil |
title_short |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
title_full |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
title_fullStr |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
title_full_unstemmed |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
title_sort |
Dispensing errors in a Rio de Janeiro tertiary hospital: incidence, types, and causes / Erros de dispensação em hospital terciário do Rio de Janeiro: incidência, tipos e causas |
author |
de Moura, Luciana Lima |
author_facet |
de Moura, Luciana Lima Cunha, Rafael Garcia Fonseca, Ana Beatriz Monteiro de Brito, Monique Araújo de Castilho, Selma Rodrigues |
author_role |
author |
author2 |
Cunha, Rafael Garcia Fonseca, Ana Beatriz Monteiro de Brito, Monique Araújo de Castilho, Selma Rodrigues |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
de Moura, Luciana Lima Cunha, Rafael Garcia Fonseca, Ana Beatriz Monteiro de Brito, Monique Araújo de Castilho, Selma Rodrigues |
dc.subject.por.fl_str_mv |
medication errors dispensing errors hospital pharmacy service Brazil |
topic |
medication errors dispensing errors hospital pharmacy service Brazil |
description |
Objective: In this study, the drug dispensing system of a tertiary care center was analysed, with the purpose of identifying the occurrence of dispensing errors, their types, causes, and the role of double checking in prevention. The main factors that contribute for the errors and the recommendations to avoid them have been evaluated from the perspective of the professionals involved in the dispensation process. Methods: 1,077 prescriptions were assessed in a 6-month period. The errors were recorded and corrected before the medication left the pharmacy. Each pharmaceutical unit dispensed was considered as a possibility of error. The results were analyze through descriptive statistics (average, median, standard deviation, coefficient of variation, and frequencies). In the second step of the research, the opinion of the professionals directly involved with dispensing about causes and consequences of the errors was assessed through a questionnaire with open and closed questions to explore the factors and causes of errors. Results: A 4.5% rate of dispensing errors inside the pharmacy was observed , during the double-check process. The rate observed when the medicines arrived at the admission units was of 0.37%. The most frequent class of errors in dispensing was drug omission (62.9%), followed by dose added errors (11.7%); incorrect time (10.2%); incorrect drug (9.2%), and changed dosage form (6.4%). We found a direct relationship between the number of dispensed items during a shift and the number of dispensing errors (?=0,844). The schedule for team shifts influenced the error rate (p=0,016). Conclusion: Knowing the dispensing error profile is crucial for promoting behaviour changes and to define adequated error barriers. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-29 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/32069 10.34119/bjhrv4n3-351 |
url |
https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/32069 |
identifier_str_mv |
10.34119/bjhrv4n3-351 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/32069/pdf |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Brazilian Journal of Health Review info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Brazilian Journal of Health Review |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Brazilian Journals Publicações de Periódicos e Editora Ltda. |
publisher.none.fl_str_mv |
Brazilian Journals Publicações de Periódicos e Editora Ltda. |
dc.source.none.fl_str_mv |
Brazilian Journal of Health Review; Vol. 4 No. 3 (2021); 14181-14194 Brazilian Journal of Health Review; v. 4 n. 3 (2021); 14181-14194 2595-6825 reponame:Brazilian Journal of Health Review instname:Federação das Indústrias do Estado do Paraná (FIEP) instacron:BJRH |
instname_str |
Federação das Indústrias do Estado do Paraná (FIEP) |
instacron_str |
BJRH |
institution |
BJRH |
reponame_str |
Brazilian Journal of Health Review |
collection |
Brazilian Journal of Health Review |
repository.name.fl_str_mv |
Brazilian Journal of Health Review - Federação das Indústrias do Estado do Paraná (FIEP) |
repository.mail.fl_str_mv |
|| brazilianjhr@gmail.com |
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1797240064311296000 |