Something as simple as keeping pharmacy counters free of clutter is important for reducing medication errors because of high volume, inadequate staffing, and demanding patients. Pharmacies should use a basket system to keep patients’ prescriptions and drugs separate and to remove containers from completed prescriptions.
Errors occur with unverified call in orders. Pharmacists should write the order down and confirm that it was correctly heard. Spelling the names during read back provides more protection.
E-prescriptions have special problems such as the inability of prescribers finding the proper drug strength or dosage form on the prescribing dropdown menu. Instead they select a similar drug from the list and write in the intended product in notes in other prescription areas which may be missed during entry.
Scanning barcodes can avoid the most common errors by checking the correct drug, dosage form and strength. But orders must be entered in the system before selecting the medication bottle. If pharmacists take the wrong drug from the shelf and enter its NDC number, barcoding will miss that error because the wrong barcode will be on the prescription label.
There are many drugs with look-alike and sound-alike names. This keeps increasing as more drugs become available in generic form.
Pharmacies should select five common LASA pairs and prepare strategies to avoid errors with them such as separation. When drugs are separated, however, pharmacists and techs must know their location.
A second pharmacist or appropriately licensed technician can help find errors by verifying prescriptions. This should include the original order entry by keeping the paper prescription with the label and medicine bottle until completion or by reviewing the scanned prescription on the computer screen.
Pharmacy software systems should change some alerts to hard stops so the pharmacist or technician must stop, read the alert, and type a response. Shelf talkers alerting staff about LASA drugs should be moved around so they still receive attention.
Patients can catch errors. When they pick up a prescription, patients should confirm its accuracy by looking at the label and the drug name and verify that it looks like the drug if they received it before. Patient counseling provides important information on taking the drug and may catch errors if it conflicts with what the physician told the patient.
Errors can be catastrophic or fatal. An attorney can help victims, or their families seek compensation and damages for medication errors.