Pharmacy Dispensing Errors and Strategies

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Questions and Answers

What is the primary reason for the dispenser's mistake in the hypothetical case described?

Inadequate labeling of the medication

Inadequate patient counseling

Poor handwriting by the prescriber (correct)

Dispenser's lack of knowledge of the medication

What is the consequence of dispensing the wrong medication to a patient?

Excessive bleeding (correct)

Minor allergic reaction

Nausea and vomiting

Headache

What is the primary way to prevent dispensing errors?

Interpretation of prescription carefully (correct)

Counting of medication by two technicians

Color-coding of medication labels

Use of automation in dispensing

What should be done when a prescriber's handwriting is illegible?

Contact the prescriber for clarification Signup and view all the answers

What should be included in a complete drug order?

Medication and dosage instructions Signup and view all the answers

What is the purpose of specifying the route of administration?

To prevent medication errors Signup and view all the answers

What is the consequence of dispensing expired medications?

Reduced medication effectiveness Signup and view all the answers

What should be avoided when writing prescriptions?

Abbreviating drug names Signup and view all the answers

What is the primary step in preparing and labeling items for issue?

Interpreting the prescription carefully Signup and view all the answers

When specifying a drug name, what should be used?

TALL MAN lettering Signup and view all the answers

What is the main purpose of calling the prescriber to clarify any uncertainties or doubts regarding the prescription?

To confirm that the prescription is correct and complete Signup and view all the answers

What is the primary reason for beware of look-alike, sound-alike drugs (LASA)?

Some of these errors are fatal Signup and view all the answers

What can be a common cause of medication errors due to misinterpretation?

Misplaced zeros, decimal points, and faulty units Signup and view all the answers

What can help facilitate a smooth flow from one task to the next, thus reducing the chances of dispensing errors?

Proper lighting, adequate counter space, and comfortable temperature and humidity Signup and view all the answers

What is the recommended approach to rechecking in a pharmacy setting?

Immediate rechecking by a colleague Signup and view all the answers

What can be a strategy to minimize dispensing errors?

Reduce distraction and multitasking when possible Signup and view all the answers

What should be done to reduce the risk of dispensing errors?

Lock-up drugs with a high potential of error Signup and view all the answers

What is the primary goal of providing thorough patient counseling?

To promote patient involvement in their healthcare Signup and view all the answers

What is the primary purpose of the Triple Check System?

To thoroughly check the dispensed prescriptions Signup and view all the answers

What is the ideal scenario for pharmaceutical services in hospitals?

24 hours a day, 7 days a week Signup and view all the answers

What should be avoided when writing a drug strength?

Using trailing zeros Signup and view all the answers

What is a common method of off-hour dispensing in hospitals?

Use of nursing supervisors Signup and view all the answers

What is the primary concern with using nursing supervisors for off-hour dispensing?

Illegal practice in some hospitals Signup and view all the answers

What is the purpose of an emergency box in a hospital?

To store equipment for emergency situations Signup and view all the answers

What is the primary purpose of evaluating and validating a prescription during the dispensing process?

To check the prescription's completeness, legality, and authenticity Signup and view all the answers

What is a potential benefit of using emergency boxes in hospitals?

Enhancing timely access to emergency supplies Signup and view all the answers

What is the correct sequence of steps in the dispensing cycle?

Receive and validate prescription, understand and interpret, issue medicine to patient Signup and view all the answers

Why is it essential to separate the pharmacy area from the permitted area when using nursing supervisors for off-hour dispensing?

To maintain pharmacy security and control Signup and view all the answers

What is the primary goal of educating patients about safe and effective use of their medication?

To promote patient involvement in their healthcare Signup and view all the answers

What is the primary purpose of assessing prescriptions during the dispensing process?

To determine whether individual prescriptions should be dispensed or not Signup and view all the answers

What is the correct method of packaging medicines during the dispensing process?

Packaging medicines to optimize safety Signup and view all the answers

What should be avoided during the dispensing process?

Dispensing without a prescription, incomplete, confuse, or from an unauthorized prescriber Signup and view all the answers

What is the primary purpose of handover of the dispensed drugs during the dispensing process?

To provide patient counseling regarding proper usage and storage Signup and view all the answers

What is the primary purpose of maintaining a dispensing record during the dispensing process?

To provide a record of the dispensing process Signup and view all the answers

What is the primary purpose of prioritizing prescriptions during the dispensing process?

To prioritize prescriptions based on urgency Signup and view all the answers

What is the primary purpose of reviewing the prescribed medicine during the dispensing process?

To check the drug safety Signup and view all the answers

What is a major drawback of the 'Use of Physician' system in off-hour dispensing?

Unfamiliar surroundings for physicians in pharmacies Signup and view all the answers

What is the primary advantage of the 'Pharmacist-On-Call' system in off-hour dispensing?

Reduced burden on individual pharmacists Signup and view all the answers

In which scenario would a hospital utilize the 'Purchased Service' system in off-hour dispensing?

When there is limited staff pharmacists or pharmacists are on leaves Signup and view all the answers

What is the primary reason for switching from off-hour dispensing to full-time service?

To provide continuity in pharmaceutical services Signup and view all the answers

What is a key benefit of the 'Pharmacist-On-Call' system in terms of preventing medication errors?

Improved medication error prevention Signup and view all the answers

In the 'Purchased Service' system, what should be invited by the pharmacies to avoid politics or favoritism?

A bid for pre-described pharmaceutical services Signup and view all the answers

What is a key benefit of full-time service in terms of night staff?

Providing medication to night staff Signup and view all the answers

What is a key drawback of the 'Use of Physician' system in terms of pharmacists?

Burden and shortage of physicians Signup and view all the answers

What is a key advantage of the 'Purchased Service' system in terms of hospital operations?

Cost-effective solution for hospitals Signup and view all the answers

Study Notes

Dispensing during Off Hours

Dispensing of drugs or medicines involves preparation, packaging, labeling, record-keeping, and distribution to a patient or an intermediary responsible for administration.

Drug Dispensing Elements and Activities

Evaluate and validate prescription, checking completeness, legality, and authenticity.
Assess prescriptions, determining whether to dispense or not.
Prioritize prescriptions, considering stock availability of prescribed medicines.
Correct dispensing procedures involve evaluating and validating prescriptions, reviewing prescribed medicine, checking drug safety, filling prescriptions accurately, packaging medicines to optimize safety, calculating and informing total cost, maintaining dispensing records, and handing over dispensed drugs with patient counseling.

Dispensing Cycle

Receive and validate prescription.
Understand and interpret prescription.
Prepare and label items for issue.
Make a final check.
Issue medicine to patient with clear instructions and advice.

Categories of Dispensing Errors

Wrong dispensing of medicines could be categorized as:
- For the wrong patient.
- The wrong medicine.
- The wrong drug strength.
- The wrong quantity.
- Expired drugs.
- Incorrect drug strength.
- Incorrectly compounded medicine.
- The wrong information on the label.

Strategies for Minimizing Dispensing Errors

Readable handwriting or computer-generated prescription.
Interpret prescription carefully or clear oral communications.
Writing complete drug orders.
Do not hesitate to contact prescriber for clarification.
Use generic and brand names when possible.
Avoid abbreviating drug names.
Specify the route of administration.
Use TALL MAN lettering in drug name.
Specify the drug strength, e.g. 100mg.
Avoid trailing zeros and decimal points.
Specify directions for when required medicines, including frequency, total daily dose, and indication for use.

Strategies for Minimizing Dispensing Errors (continued)

Confirm that the prescription is correct and complete.
Beware of look-alike, sound-alike drugs (LASA).
Be careful with zeros and abbreviations.
Organize the workplace properly.
Reduce distraction and multitasking when possible.
Focus on reducing stress and heavy workloads.
Take the time to properly store drugs and other items.
Thoroughly check the dispensed prescriptions (Triple Check System).
Always provide thorough patient counseling/guidance.

Off Hour Dispensing

Pharmaceutical services should be available 24 hours a week.
In hospitals without round-the-clock pharmaceutical services, procurement and distribution of drugs and ancillary supplies could be done according to different processes.

Off Hour Dispensing Methods

Use of Nursing Supervisors: most common method, but criticized and illegal in some hospitals.
Emergency Boxes: used in large teaching hospitals or tertiary care hospitals, having all the supplies present on the emergency bases.
Use of Physician: not recommended due to drawbacks, such as burden and shortage of physicians, and unfamiliar surroundings.
Pharmacist-On-Call: organizations contract with pharmacists to serve round the clock, supported by bonus or extra payment plans.
Purchased Service (Community Pharmacy acquired services): hospitals may obtain services of community pharmacy for drug supply in the hospital, called off-site pharmacy service.

Switching from Off Hour Dispensing to Full-Time Service

Reasons for switching include:
- Providing continuity in services such as drug information and monitoring, IV admixture, unit dose programs, and prevention of medication errors.
- Providing medication to night staff, which is least experienced.

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Description

This quiz covers important guidelines for pharmacy dispensing, including rules for writing drug names and directions, and strategies for minimizing dispensing errors.