Pharmacists and their teams handle vast volumes of prescriptions daily. It is an important job that requires careful attention.
However, mistakes can happen easily with heavy workloads and limited staff. Dispensing errors - like giving someone the wrong medication dosage or even the incorrect medicine - can be a serious problem for patients and your pharmacy's reputation.
Discover how to reduce risk and manage dispensing errors at your pharmacy, and learn how working with an industry leader can significantly help optimize your processes.
What Is a Dispensing Error?
A dispensing error is a discrepancy between a prescription and the medication delivered to a patient. It occurs in a pharmacy or any establishment that provides medication. Although it is preventable, it is considered one of the significant reasons for prolonged hospitalization, increased healthcare costs and therapeutic failure.
The Most Common Error Types
The commonly reported errors in pharmacies include:
Wrong Dosage Strength or Form
Medications have varying strengths and formulations. Similar names, packaging or formulation appearance can lead to selection errors, especially when a pharmacist is distracted or under time pressure.
Dispensing an Incorrect Medication
Various factors can cause this error. A pharmacist may have failed to check the dispensed medication before giving it to the patient. Moreover, look-alike or sound-alike (LASA) drug names may cause confusion. For instance, a provider may confuse clonazepam, an anti-seizure medication, with clonidine, a blood pressure drug.
Failure to Identify Drug Interactions or Contraindications
Pharmacists undergo extensive training that allows them to identify and avoid potential drug interactions. However, this error may still occur when they don't spend enough time reviewing a patient's background or existing medications. Complex patient profiles, medication lists and inadequate clinical decision support systems may also contribute to this mistake.
Miscalculating a Dose
Dosage calculations can be prone to errors. Failing to consider patient-specific factors, like weight or preexisting conditions, simple arithmetic mistakes or using the wrong formula can all lead to miscalculations.
Why Dispensing Errors Happen
Dispensing medication is significantly dependent on human input. Pharmacists must evaluate the clinical appropriateness of prescriptions, interpret what was written and ensure that orders are fulfilled successfully. In addition, the workload and workplace can contribute to the likelihood of errors. A study used five categories to determine the factors contributing to dispensing mistakes.
Individual Factors
Many study participants stated that various dispensing errors were due to junior prescribers writing prescriptions. Moreover, fatigue and emotional stress affect their functionality. Lack of knowledge, inadequate training and poor policy compliance were also contributing factors.
Organization and Management Factors
Insufficient staff support systems, difficulties in work regulation, low salary and lack of task clarification can also affect the providers, which may lead to dispensing errors.
Task Factors
Some task-related factors include the lack of standardization and a decision-supporting information system.
Work Factors
Distractions from phone calls, unauthorized entrances and constant foot traffic - combined with heavy workloads and multitasking demands - can compromise a pharmacist's focus. This could lead to dispensing errors and reduced opportunities for critical double-checks and continuing education.
Team Factors
The lack of teamwork and effective communication can make proper dispensing more challenging. Several issues with prescribers, like incomplete patient information, can also make it difficult for providers to calculate doses.
How to Reduce Risk and Manage Dispensing Errors at Your Pharmacy
Automation is a game-changer in reducing risks and errors in pharmacies by minimizing human intervention and standardizing processes. Capsa Healthcare is a leading provider of automated medication solutions, optimizing workflows and promoting reliable record-keeping. With its solutions implemented in over 60% of U.S. pharmacies, the company helps create a more controlled, precise and error-resistant environment, ultimately improving patient safety.
Capsa Healthcare can help reduce risk and manage dispensing errors at your pharmacy by:
Improving Inventory Management
Many pharmacies worry about inventory management. Capsa Healthcare offers advanced inventory management tools, like KL1Plus C-II Log Software, that promote efficient inventory tracking and reduce the risk of an audit complication or diversion. Additionally, it offers secure, user-friendly medication carts that provide versatile storage solutions, making it easier for providers to acquire common items.
Reducing Human Involvement
Many Capsa Healthcare automation tools eliminate routine tasks so pharmacists can focus on patient-centered care. For instance, the KL1v Tablet Counter promotes precise prescription counting in environments where accurate batch counting is critical. Some devices, like the KL1Plus, have computerized scan verification to ensure prescriptions are filled properly. Complete orders in less time than traditional hand-counting.
Ensuring Accurate Dispensing Practices
Fully automated dispensing robots eliminate the risk of errors, allowing pharmacies to automate 50%-60% of their daily prescriptions. The reduced dependence on human input can reduce work-related stress, allowing providers to focus on other high-value tasks that require concentration.
Other Ways to Prevent Dispensing Errors
Aside from investing in automated dispensing solutions, implement these strategies to reduce the risk of dispensing mistakes.
Verify the Patient's Prescription
Errors can happen when prescriptions are conveyed via phone. Repeated checking and counterchecking are crucial to ensure accurate information. Compare the written prescription with the item on the computer, the printed label and the medication being dispensed for your and the patient's peace of mind. Whenever possible, ask a colleague to double-check.
When the patient picks up their medication, take a few minutes to converse with them. Ask about their age, body weight and existing medications before handling their orders. Consider allergies and liver and kidney function to avoid unwanted side effects.
Provide Patient Counseling
Healthcare professionals must provide information about appropriate medication as part of any error-prevention activity. Proper counseling empowers people to take charge of their health and prevent mistakes. Consider giving instructions for the following:
- Medication names and indications
- The number of times medication should be administered
- Correct dosage
- Medication information sheet
- Proper drug storage
- Potential drug interactions
To enhance patient safety, pharmacists must open the container and show the medication rather than dispensing it in a sealed bag. This allows customers to verify the drug's appearance and ask questions if it differs from what they expect.
Reorganize Your Inventory
Efficient medicine dispensing requires a balanced inventory. However, achieving this can be challenging. Bulk ordering drugs can lead to storage problems and wasted products, while stocking too little increases the risk of running out of critical medications. Instead of overloading your storage area, keep essential meds readily available. This approach will allow the team to respond quickly to orders while maintaining product quality.
For instance, during high-demand periods like flu season, your pharmacy can store antiviral drugs in easily accessible places. Instead of stacking boxes, use medication cabinets or carts that allow better storage and visibility. Improving storage access and management reduces stress and dispensing delays.
Conduct Internal Process Improvements
Proactive system interventions provide added protection against dispensing errors. Capsa Healthcare offers complete central fill automation solutions to reduce manual labor requirements, boost scripts-per-square-foot efficiency and ensure optimal operations. It thoroughly evaluates SKU distribution, workflows, prescription volume and available space. After the assessment, the team creates a design based on your current operations and expansion plans.
Pharmacies must also regularly assess the root causes of errors and implement corrective measures. For instance, if LASA drug confusion is a primary factor, practical solutions include storing these medications in separate locations within the storage area and ensuring that all bottles are clearly labeled and facing forward. Routine checks to remove expired and compromised items are also essential.
Implement Technological Upgrades
Modern tools can help minimize errors, allowing pharmacists to focus on providing patient care. Applying technology to processes like prescription filling with Capsa Healthcare's KL1Plus can make processes more efficient and accurate. Utilizing advanced technology helps you build a lasting relationship and impression with customers.
An automated will-call system with scripClip is an excellent addition to retail and hospital outpatient pharmacies. It helps staff quickly locate the proper medications and prescriptions for patients. The modular and pick-to-light system uses LED-enabled hanging Rx bags or clip-ons to guide pharmacy staff.
When a prescription is filled and ready for pickup, it is placed in a scripClip hanging bag. The system uses LED and sound alerts to guide the pharmacist to the correct order. Once the patient arrives, it directs staff to the correct bag via light and sound cues. The will-call system returns prescriptions to stock in case of failed pickups, reducing waste and errors.
Train Your Team
Every employee must know how to handle prescriptions with proper care, understanding and accuracy. When your staff knows how to label medications, check prescriptions and provide patient counseling, the risk of dispensing errors lessens. Conduct refresher training sessions about the step-by-step process for efficient medicine dispensing or seminars about the proper use of automated devices.
Here's what a safe medicine dispensing process looks like:
Prescription Receipt and Review
The pharmacist receives the electronic or written prescription and verifies its authenticity. They note key patient information, prescriber details, date issued, drug names, dosage, duration, frequency and refills. If they have any uncertainties when reading the prescription or the dosage seems unusual, they must notify the prescriber and ask for clarification.
Patient Profile Review
Next, the pharmacist must check for allergies, drug interactions, contraindications and duplicate therapies to ensure the safe administration of prescribed medications. The professional must also consider patient-specific information like age, weight and pregnancy status.
Medication Selection
The provider selects the correct medication, strength and dosage form. They compare the label to the prescription and double-check for LASA drugs. Fully automated dispensing robots offer great value at this step, providing busy pharmacies with precision, accountability and security.
Dosage Calculation
After medication selection, the provider calculates the correct dose and double-checks everything, especially for high-risk medications.
Dispensing and Labeling
Instead of hand counting, pharmacies can use Capsa Healthcare's tablet counters for fast and accurate measurement. An automated packaging system provides flexibility for multidose and unit-dose dispensing. The provider affixes a clear label to the medication container, including patient name, drug name and strength, dosage instructions, pharmacy details, prescriber name, date dispensed, refill reminders and any necessary warnings.
Verification and Patient Counseling
The pharmacist completes a final review and compares the medication to the prescription and label. Once done, they show the patient the medication and convey reminders, such as potential side effects and storage instructions.
Documentation
After the transaction, the pharmacist will record the dispensing information in the system and document any clarifications or interventions made during the process.
Take Care of Your Staff
Pharmacies often face pressure to dispense a high volume of prescriptions quickly, with various establishments operating with inadequate staffing levels. This is a prevalent issue, with approximately 51% of pharmacists experiencing burnout. Automated medication dispensing systems and packaging can help decrease the need for manual labor.
Establish a distraction-free zone where staff can dispense and double-check medication. When employees are not overwhelmed, they have the mental capacity to provide thorough patient counseling, leading to better health outcomes.
However, these interventions can only do so much. You must prioritize the well-being of your staff. A happy and well-supported team is more motivated and engaged, leading to faster and more accurate dispensing. Consider the following strategies to help combat workplace burnout:
Offer Flexible Scheduling
Give staff some flexibility in working hours or shift patterns. Allow them to manage personal appointments, attend to family needs and get proper rest.
Create a Supportive Work Environment
Open avenues for pharmacists to feel comfortable voicing concerns, sharing ideas and providing feedback. Implement one-on-one check-ins or anonymous suggestion boxes. Make sure to follow through so they feel seen and heard.
Provide a Safe and Ergonomic Workspace
A safe, conducive environment is crucial to ensure accurate dispensing and verification of prescriptions. See that the pharmacy remains clean and organized. Invest in comfortable chairs and other equipment to reduce physical strain.
Designate De-Stressing Zones
If you have ample space, designate a small, quiet area in the pharmacy where a tired employee can take a brief break or practice mindfulness exercises. A comfortable chair, calming decor and a stock of nutritious snacks can make a difference.
Cross-Train Staff
Ensure technicians are properly trained to handle a broader range of tasks, such as insurance billing, documentation, inventory management, and basic patient information verification to support pharmacists and balance workload.
Commit to Safety and Accuracy
Giving out the right medicines keeps patients safe and protects your pharmacy's reputation. Implement these strategies to reduce mistakes and ensure peace of mind for your team and your loyal customers. A meaningful step toward this goal is investing in innovative, automated tools to strengthen your pharmacy's legacy of high-quality care.
CEO of Capsa Healthcare, Gaurav Agarwal, brings over 25 years of leadership experience in driving commercial success and innovation across the healthcare IT, diagnostics and medical devices sectors.
Photo source: depositphotos.com
