Medication Errors

[JennyRx2007]

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http://www.usatoday.com/money/industries/health/2008-02-11-prescription-errors_N.htm?csp=34
Very interesting article especially if you're working in a chain retail setting. I'm sure some of you have already read the article. If you haven't, it's a great article to read. Feel free to discuss about this as I'm growing more and more frustrated with my work condition and always afraid that I'm giving out the wrong med 😡

 

[fhx06]

I'm not surprised, to be honest. It is slightly different in the hospitals but for the most part, errors occur as a result of the amount of patients needing medications and the emphasis placed on speed. Humans are not perfect, and the compounding stress and increasing pressure only adds to the problem. Despite what a corporation says about "'no pharmacist has to fill a single prescription more during the workday than they feel is safe'", the amount of work from phone calls, patient counseling, medication verification, etc. require a lot more help than a strict budget can provide.

 

[Old Timer]

Can you find something a little more current? If you are having a problem with stress at work, share the details. Maybe some us could help you.

 

[Doctor M]

Can you find something a little more current? If you are having a problem with stress at work, share the details. Maybe some us could help you.

More current? Although this article is from a year ago, this is in fact the truth of retail pharmacy! and 477 rx's between 2 pharmacists! Crap, I gotta get out of my current setting! We do like 475 -500 avg with no overlap. Overnight will do like 50-75 rx's, so we are doing 400 daily with no overlap...no breaks, just crap about readyfill and PCI...

 

[Old Timer]

I want someone to tell me how many prescriptions can safely be filled in in one day, in one hour? Does technology play a role? Can you fill more prescriptions per hour with a computer than with a typewriter? Is volume the only thing that causes errors? Do you really think there is a correlation between volume and errors? I have no data to back it up, but I have seen errors at every volume from 600 per week to 5000 per week. I think the amount of support staff is a factor. I think stores that have low volume with one pharmacist and one tech are just as dangerous as higher volume stores that have more ancillary help.

I really think the level of ancillary help is more of a contributing factor than the number of scripts per pharmacist per hour. If think distractions are a greater cause of errors than volume.

 

[acetyl]

How do you mistake Inderal for Methitest? Twice? The filling technician must have been blind

 

[MountainPharmD]

Despite what a corporation says about "'no pharmacist has to fill a single prescription more during the workday than they feel is safe'", the amount of work from phone calls, patient counseling, medication verification, etc. require a lot more help than a strict budget can provide.

Thats the thing....who fills the prescription if you feel it is unsafe to fill any more? I just got 16 tech hours wacked out of my budget. Hell we are going to be almost as bad as CVS.

 

[Old Timer]

How do you mistake Inderal for Methitest? Twice? The filling technician must have been blind

Technicians don't make mistakes, pharmacists make mistakes.....

 

[JennyRx2007]

I want someone to tell me how many prescriptions can safely be filled in in one day, in one hour? Does technology play a role? Can you fill more prescriptions per hour with a computer than with a typewriter? Is volume the only thing that causes errors? Do you really think there is a correlation between volume and errors? I have no data to back it up, but I have seen errors at every volume from 600 per week to 5000 per week. I think the amount of support staff is a factor. I think stores that have low volume with one pharmacist and one tech are just as dangerous as higher volume stores that have more ancillary help.

I really think the level of ancillary help is more of a contributing factor than the number of scripts per pharmacist per hour. If think distractions are a greater cause of errors than volume.

I's hard to say how many scripts can safely be filled in one day because it does really depend on the amount of help that you have. Sadly, we all know that chain pharmacies tend to provide the least amount of help possible to their pharmacists so you are basically screwed regardless. However, at busier stores, you tend to run into more problem scripts and pharmacists would need to handle those problem scripts (i.e doctor calls). Only takes a few problem scripts to get you behind in verifying scripts. When you see totes, and totes of rx that needs to be check while there are incoming doctor calls, patient calls, drive-thru screaming at you, I'd say that play a huge role in pharmacist making errors....Really sad, but that is what many pharmacists including myself has to deal with on a daily basis.

 

[Doctor M]

I want someone to tell me how many prescriptions can safely be filled in in one day, in one hour? Does technology play a role? Can you fill more prescriptions per hour with a computer than with a typewriter? Is volume the only thing that causes errors? Do you really think there is a correlation between volume and errors? I have no data to back it up, but I have seen errors at every volume from 600 per week to 5000 per week. I think the amount of support staff is a factor. I think stores that have low volume with one pharmacist and one tech are just as dangerous as higher volume stores that have more ancillary help.

I really think the level of ancillary help is more of a contributing factor than the number of scripts per pharmacist per hour. If think distractions are a greater cause of errors than volume.

distractions...i usually have baskets piled up, the phone ringing, the doctors line going and that god awful ringback telling me that someone is on hold...all that plays a factor...and yes, volume does play a factor...im never relaxed, im never focused on just one task...CVS doesnt pay me to sit back there and verify all day...they have made that clear...they want verification, consults, MD calls, etc all done with minimum help...and yea, we all make mistakes at any volume level, but im just waiting for someone to get seriously hurt...or worse, killed...Everyday of my life i just pray that no one calls out sick or that we wont fill 500-600 that day...im getting out soon...and its also the quality of your help...

 

[Doctor M]

I's hard to say how many scripts can safely be filled in one day because it does really depend on the amount of help that you have. Sadly, we all know that chain pharmacies tend to provide the least amount of help possible to their pharmacists so you are basically screwed regardless. However, at busier stores, you tend to run into more problem scripts and pharmacists would need to handle those problem scripts (i.e doctor calls). Only takes a few problem scripts to get you behind in verifying scripts. When you see totes, and totes of rx that needs to be check while there are incoming doctor calls, patient calls, drive-thru screaming at you, I'd say that play a huge role in pharmacist making errors....Really sad, but that is what many pharmacists included myself has to deal with on a daily basis.

so sad...im with you...🙁

 

[acetyl]

Technicians don't make mistakes, pharmacists make mistakes.....

Actually, if the technician put the wrong drug in that bottle, yes, then they DID make a mistake.

 

[MountainPharmD]

Actually, if the technician put the wrong drug in that bottle, yes, then they DID make a mistake.

...and the pharmacist failed to catch it. Therefore it is the pharmacists mistake, if the medication reached the patient.

 

[fhx06]

This is still a team effort from both the technicians and pharmacists. Legally, the blame would fall on the pharmacist so I guess that's the major issue at hand.

 

[Vitamin K]

Technicians don't make mistakes, pharmacists make mistakes.....

Yes, technicians DO make mistakes. What you're referring to is liability. The pharmacist is liable because their mistake was failing to catch that error and prevent the rx from being dispensed. That doesn't mean that the tech did nothing wrong.

 

[Carboxide]

Can someone explain how the wrong medication could have been filled TWICE, and the SAME wrong med? I'm wondering if the script was typed in wrong the first time, with that being the real issue. In that case, the pharmacist would not have been able to notice it was wrong unless they knew it was for a child with tremors and hyperactivity...right?

 

[acetyl]

...and the pharmacist failed to catch it. Therefore it is the pharmacists mistake, if the medication reached the patient.

I'm not disputing that. You're failing to admit the obvious, you and Old Timer, actually.

Recall what happened in Ohio with a technician making a 23% saline solution instead of NS? What has that done to pharmacy in Ohio.....???

Oh, that's right. New technician licensing rules, among other technician related things. Seems weird since "technicians don't make mistakes". You people are absurd.

 

[Sparda29]

How the **** can someone mistake those two drugs? They aren't even close in spelling. I can understand hydralazine being mistaken for hydroxyzine...but this is just pathetic.

#1 - Drugs don't even come close to each other in spelling.
#2 - Shouldn't the system have flagged them when a 5 year old is getting that kind of medication?
#3 - Shouldn't the pharmacist have known that kids don't get those kinds of medications?
#4 - No way that the patient was properly counseled, the parents would have caught the mistake if they were properly counseled about the wrong medication.
#5 - The same mistake..again!!!!

 

[MountainPharmD]

I'm not disputing that. You're failing to admit the obvious, you and Old Timer, actually.

HEY!!! Don't lump me in with that crazy old fool!

Technicians make mistakes all the time, actually everyone does we are human after all. What we are specifically discussing are medication errors. If a patient gets the wrong medication it is the pharmacists mistake for not catching it.

Go in front of the state board and tell them you are not responsible for a medication error because it was the technician who filled it. See how far that gets you.

 

[dangerdog]

wasn't there a 20/20 show about pharmacy errors a year or 2 ago? Yeah, it's pretty bad, but what do you expect in the for-profit-slaving world of retail pharmacy?

 

[dangerdog]

here, I found the link.
part 1
[YOUTUBE]http://www.youtube.com/watch?v=cT5GJL0tEto[/YOUTUBE]
part 2
[YOUTUBE]http://www.youtube.com/watch?v=TxT8Gb4tp1I&feature=related[/YOUTUBE]

 

[Megas]

Actually, if the technician put the wrong drug in that bottle, yes, then they DID make a mistake.

No, you're the gatekeeper, it's your mistake if you didn't catch it.

 

[Apteka]

I do not understand how this error occurred.
"How do you mistake Inderal for Methitest?"

And i really hate how the article doesn't even get into how this could have happened. Doctor's handwriting? barcode scan error? typing error? verification error?

As for the number of RXs, i agree that the finger pointing should not immediately be to the number of RXs filled.
It has a LOT to do with the workflow with the staff on hand and the overall relationship among the pharmacy staff itself.

I just wish I understood WHY this happened. otherwise, this article is pretty useless. (to figure out why)
O wait, it's USA today. nevermind.

 

[Old Timer]

I do not understand how this error occurred.
"How do you mistake Inderal for Methitest?"

And i really hate how the article doesn't even get into how this could have happened. Doctor's handwriting? barcode scan error? typing error? verification error?

As for the number of RXs, i agree that the finger pointing should not immediately be to the number of RXs filled.
It has a LOT to do with the workflow with the staff on hand and the overall relationship among the pharmacy staff itself.

I just wish I understood WHY this happened. otherwise, this article is pretty useless. (to figure out why)
O wait, it's USA today. nevermind.

This is the way media works. You only understand it because you are involved in the issue.