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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barker KN, McConnell WE. The problems of detecting medication errors in hospitals. Am J Hosp Pharm 1962;19:360-9.
Crooks J, Clark CG, Caie HB, Mawson WB. Prescribing and administration of drugs in hospitals. Lancet 1965;i: 373-8.
Vere DW. Errors of complex prescribing. Lancet 1965;i: 370-3.
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.
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.
Hill PA, Wigmore HM. Measurement and control of drugadministration incidents. Lancet 1967;i:671-4.
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.
Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm 1990;47:555-71.
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.
Bonal J, Morato L, Pardo C, Sala M. Actualitzacio Farmacia: Los errores de medication en el hospital. Farmacia 1981;6: 195-6.
Cesur S. Ilaç uygulamalarinda hems,irelerin hata olarak görmedikleri durumlarin saptanmasina yönelik bir çalişma. Türk Hemşireler Dergisi 1988;38: 22-5.
Gutierrez-Suela F, Gonzales-Gero Y. Estudio de errores de medicacion. Farmacia Hospitalaria 1993;17:161-2.
Meyer HJ, Panter U, Wever K. Arzneimittelverteilung auf Station-eine Untersuchung. Krankenhauspharmazie 1983;4: 4-8.
Mehrtens T, Carstens G. Medikationsfehler auf Station – Ergebnisse einer Untersuchung. Krankenhauspharmazie 1997;18: 168-70.
Reißer C, Großharth E. Arzneimittelsicherheit im Krankenhaus. Krankenhauspharmazie 1996;17: 340-4.
Decker G, Meyer HJ. Kardex-System auf der Station. Krankenhauspharmazie 1988;9: 405-7.
Schommer W, Göbel H, Geller H. Patientenorientierte Medikationserfassung und Belieferung. Krankenhauspharmazie 1993;14:161-5.
Göbel H, Schommer W, Geller H. Automatisierte patientorientierte Arzneimittelbelieferung. Krankenhauspharmazie 1993;15:462-5.
Negele HJ. Unit dose-ein neues Verteil-und Dokumentationssystem für Arzneimittel. Krankenhauspharmazie 1994; 15:456-61.
Uzych L. Medication errors-beyond frequency (letter). Am J Health-Syst Pharm 1996;53:1079.
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.
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.
Gardner MJ; Altman DG. Statistics with confidence-confidence intervals and statistical guidelines. London: BMJ Publications, 1989.
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.
Gethins B. Wise up to medication errors. Pharmacy in Practice 1996;6:323-8.
Cavell GF, Hughes DK. Does computerised prescribing improve the accuracy of drug administration? Pharm J 1997;259:782-4.
Ogden DA, Kinnear M, McArthur DM. A quantitative and qualitative evaluation of medication errors in hospital inpatients. Pharm J 1997;259: R19.
Ho CYW, Dean BS, Barber ND. When do medication administration errors happen to hospital inpatients? Int J Pharm Prac 1997;5: 91-6.
Ridge KW, Jenkins DB, Noyce PR, Barber ND. Medication errors during hospital drug rounds. Quality in Health Care 1995;4:240-3.
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.
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.
Rights and permissions
About this article
Cite this article
Taxis, K., Dean, B. & Barber, N. Hospital drug distribution systems in the UK and Germany ‐ a study of medication errors. Pharm World Sci 21, 25–31 (1999). https://doi.org/10.1023/A:1008616622472
Issue Date:
DOI: https://doi.org/10.1023/A:1008616622472