Advertisement

Pharmacy World and Science

, Volume 21, Issue 1, pp 25–31 | Cite as

Hospital drug distribution systems in the UK and Germany ‐ a study of medication errors

  • Katja Taxis
  • Bryony Dean
  • Nick Barber
Article

Abstract

The aim of this study was to compare the incidence of medication errors and the stages of the drug distribution system at which they occur in a United Kingdom (UK) hospital using the ward pharmacy system, a German hospital using the unit dose system and a German hospital using their traditional system. Medication errors were identified by observing the preparation and administration of regularly scheduled solid oral medication. In the UK hospital using the ward pharmacy system, the medication error rate was 8.0% (95% confidence interval 6.2‐9.8%). The majority of these errors occurred at the stage of medication administration. In the hospital using the traditional German system, the error rate was 5.1% (4.4‐5.8%). With the German unit dose system, the error rate was 2.4% (2.0‐2.8%). In both German systems the errors were mainly attributable to the stage of transcription. It was noted that patient turnover was much higher in the wards using the ward pharmacy system and therefore the study sites may not be comparable. However, recommendations can be made in order to reduce the error rate associated with each system. Errors associated with the ward pharmacy system may be reduced if medication is stored in individual patient medicine cabinets and patients' own drugs used. Errors occurring with the traditional system and the unit dose system may be reduced if the original prescription is used for medication administration.

Drug distribution system Medication errors Traditional drug distribution system Unit dose system Ward pharmacy system 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Barker KN, McConnell WE. The problems of detecting medication errors in hospitals. Am J Hosp Pharm 1962;19:360-9.Google Scholar
  2. 2.
    Crooks J, Clark CG, Caie HB, Mawson WB. Prescribing and administration of drugs in hospitals. Lancet 1965;i: 373-8.Google Scholar
  3. 3.
    Vere DW. Errors of complex prescribing. Lancet 1965;i: 370-3.Google Scholar
  4. 4.
    Crooks J, Weir RD, Coull DC, McNab JW, Calder G, Barnett JW, et al. Evaluation of a method of prescribing drugs in hospital and a new method of recording their administration. Lancet 1967;i:668-71.Google Scholar
  5. 5.
    Barker KN, Heller WM. The development of a centralized unit dose dispensing system. Part One: Description of the UAMC experimental system. Am J Hosp Pharm 1963;20: 568-79.Google Scholar
  6. 6.
    Hill PA, Wigmore HM. Measurement and control of drugadministration incidents. Lancet 1967;i:671-4.Google Scholar
  7. 7.
    Barker KN. The effects of an experimental medication system on medication errors and costs. I. Introduction and errors study. Am J Hosp Pharm 1969;26:324-33.PubMedGoogle Scholar
  8. 8.
    Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm 1990;47:555-71.PubMedGoogle Scholar
  9. 9.
    Jaubert de Beaujeu C, Bureau J. Comparaison des taux d'erreurs de dispensation des medicaments en fonction du mode de distribution (traditionelle, nominale, manuelle et informatisee). Journal de Pharmacie Clinique 1988;7:415-24.Google Scholar
  10. 10.
    Bonal J, Morato L, Pardo C, Sala M. Actualitzacio Farmacia: Los errores de medication en el hospital. Farmacia 1981;6: 195-6.Google Scholar
  11. 11.
    Cesur S. Ilaç uygulamalarinda hems,irelerin hata olarak görmedikleri durumlarin saptanmasina yönelik bir çalişma. Türk Hemşireler Dergisi 1988;38: 22-5.Google Scholar
  12. 12.
    Gutierrez-Suela F, Gonzales-Gero Y. Estudio de errores de medicacion. Farmacia Hospitalaria 1993;17:161-2.Google Scholar
  13. 13.
    Meyer HJ, Panter U, Wever K. Arzneimittelverteilung auf Station-eine Untersuchung. Krankenhauspharmazie 1983;4: 4-8.Google Scholar
  14. 14.
    Mehrtens T, Carstens G. Medikationsfehler auf Station – Ergebnisse einer Untersuchung. Krankenhauspharmazie 1997;18: 168-70.Google Scholar
  15. 15.
    Reißer C, Großharth E. Arzneimittelsicherheit im Krankenhaus. Krankenhauspharmazie 1996;17: 340-4.Google Scholar
  16. 16.
    Decker G, Meyer HJ. Kardex-System auf der Station. Krankenhauspharmazie 1988;9: 405-7.Google Scholar
  17. 17.
    Schommer W, Göbel H, Geller H. Patientenorientierte Medikationserfassung und Belieferung. Krankenhauspharmazie 1993;14:161-5.Google Scholar
  18. 18.
    Göbel H, Schommer W, Geller H. Automatisierte patientorientierte Arzneimittelbelieferung. Krankenhauspharmazie 1993;15:462-5.Google Scholar
  19. 19.
    Negele HJ. Unit dose-ein neues Verteil-und Dokumentationssystem für Arzneimittel. Krankenhauspharmazie 1994; 15:456-61.Google Scholar
  20. 20.
    Uzych L. Medication errors-beyond frequency (letter). Am J Health-Syst Pharm 1996;53:1079.PubMedGoogle Scholar
  21. 21.
    Dean BS, Allan EL, Barber ND, Barker KN. Comparison of medication errors in an American and a British hospital. Am J Health-Syst Pharm 1995;52:2543-9.PubMedGoogle Scholar
  22. 22.
    Campbell MJ, Julious SA, Altman DG. Estimating sample sizes for binary, unordered categorical and continuous outcomes in two group comparisons. BMJ 1995;311:1145-8.PubMedGoogle Scholar
  23. 23.
    Gardner MJ; Altman DG. Statistics with confidence-confidence intervals and statistical guidelines. London: BMJ Publications, 1989.Google Scholar
  24. 24.
    Dean BS and Barber ND. How much does it matter? The development of a scale to assess the significance of medication errors. Paper presented at the 3rd Health Services Research and Pharmacy Practice Conference, London, April 1997.Google Scholar
  25. 25.
    Gethins B. Wise up to medication errors. Pharmacy in Practice 1996;6:323-8.Google Scholar
  26. 26.
    Cavell GF, Hughes DK. Does computerised prescribing improve the accuracy of drug administration? Pharm J 1997;259:782-4.Google Scholar
  27. 27.
    Ogden DA, Kinnear M, McArthur DM. A quantitative and qualitative evaluation of medication errors in hospital inpatients. Pharm J 1997;259: R19.Google Scholar
  28. 28.
    Ho CYW, Dean BS, Barber ND. When do medication administration errors happen to hospital inpatients? Int J Pharm Prac 1997;5: 91-6.Google Scholar
  29. 29.
    Ridge KW, Jenkins DB, Noyce PR, Barber ND. Medication errors during hospital drug rounds. Quality in Health Care 1995;4:240-3.PubMedGoogle Scholar
  30. 30.
    Dean BS, Kanabar PB, Ashby N, Taxis K, Barber N. What can the drug chart tell us about medication administration? The Hospital Pharmacist 1998. Accepted for publication.Google Scholar
  31. 31.
    Semple JS, Morgan JE, Garner ST, Sutherland K, Milligan M. The effect of self-administration and reuse of patients' own drugs on a hospital pharmacy. Pharm J 1995;255:124-6.Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Katja Taxis
  • Bryony Dean
  • Nick Barber

There are no affiliations available

Personalised recommendations