dispensing and dispensary Flashcards
(37 cards)
what is a dispensing error
→ when what is dispensed for the patient deviates in any way from what has been requested on the prescription: can only be caught by the pharmacist.
common dispensing errors
- wrong drug dispensed
- given to wrong patient
- drug inappropriate e.g. allergies/interactions
- wrong strength/dose/freq
- transcription errors e.g. misread mg as mcg etc
Factors contributing to dispensing errors
- the team - understaffed? do they work well together
- the individual - are they feeling well / are they worried about anything and so not thinking clearly / sleepy
- the medicines - some are harder to dispense than others e.g. calculating and making them up
- the prescription - if it misses information, if anythings incomplete, can’t decipher handwriting?
consequences of dispensing errors
- if taken away form patient e.g. They might notice it, or they might take it
- caught by pharmacy at accuracy checking stage = near miss
root cause analysis - what could have affected the dispensing?
using C.H.A.P.S acronym for dispensing
Conditions
Health of the patient
Assistance
Prescription
Systems
accuracy checking using the H.E.L.P acronym
- HOW MANY
- EXPIRY DATE
- LABEL
- PRODUCT
a THREE WAY CHECK consists of?
Plus : check expiry date of each container one item at a time
- Compare each label with the prescription:
- Checking each detail eg drug name, strength, dose, patient’s name - Check each item with the prescription
– Looking at name, strength and quantity. - Check the label and the item
– Looking at drug name, strength, and quantity
Labelling - Legal requirements
- Name of Patient
- Name & Address of the person supplying
- Date of dispensing
- Directions for use
- Keep out of reach of children
- For external use only
Labelling - Good practice
- Warning Labels / adapting to needs of patient
e.g child
- Labelling position: consider what you might be covering up
providing the correct medication: what must be correct?
name, formulation, strength, quantity, expiry, PIL, not opened
general dispensary guidelines
- tidy and uncluttered
- shelves fit for purpose
- adequate lighting and suitable heating
- no stock on the floor
- or surfaces = smooth and impervious to dirt
- floor clean and no tears
- pharmacist should be able to see and hear the counter
- written cleaning procedures should be there
- the floor, walls and shelves should be clean and dust free
- all stock should be stored within reach
- food and drink shouldn’t be consumed in dispensary
- arrangement for proper store and disposal of waste materials
why do we have guidelines for dispensary management
‘Human beings usually make mistakes because the systems, tasks and processes they work within are poorly designed. ‘ - nhs
so what can effective design do?
Effective design can deliver products, services, processes and environments that are intuitive, simple to understand, simple to use, convenient and comfortable, and consequently less likely to lead to errors - NHS
factors that should be considered when managing the dispensary environment
- signage
- lightning
- noise
- security
- privacy e.g. telephone and seating
- flooring and worktops
- temperature and ventiliation
dispensary layout workflow steps
https://www.notion.so/dispensing-and-prescriptions-1dd00bb3982d806aa330f48dd45bc7bc?pvs=4#1e800bb3982d80da8600d14519882343
1. receipt of prescription and clinical check
2. creation of label
3. medicines assembly
4. accuracy check
5. storing dispensed medicines
6. medicines collection and final accuracy check
7. patient counselling
what is involuntary automaticity
the skilled action that people develop through repeatedly practising the same activity
dispensary layout delivery of stock recommendations
make it flow in order of what is happening
safe storage of medicines in the refrigerator recommendations
- separate refrigerators for stock and completed prescriptions
- glass fronted fridges to see what is there easily
keep the dispensed items fridge near the dispensed meds collection point
monitor and record temperatures daily
safe storage of medicines in the controlled drugs cupboard recommendations
- cd cupboards need to be large enough to meet the workload of the dispensary an allow stock to be well spaded and easily seen
how should stock be separated, e.g. what should we use etc
shelf dividers (ensured diff product and formulations etc dont get mixed)
- using sloping pull out drawers that enable stock to be seen and easily retrieved may also help reduce selection errors
possible issues with patient areas
confidentiality is essential when talking about their meds
- waiting patients should not be able to hear any convos + should not be crowding the counter + disorderly queuing can cause confusion and distract both patients and staff
so how should patient areas be organised instead
patient waiting areas away from areas where confidential conversations occur
use good signage and counter dividers tc to show where confidential convos occur
A report by the Department of Health estimates that unused medicines cost the NHS around how much?
£300 million every year
how much medicine is returned to pharmacies (the worth in £)
£110 million worth
