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GPhC should collect information on dispensing errors, says academic

The regulator could use data it receives to create the "perfect dispensary environment" and prevent mistakes, says health psychologist Hannah Family

The General Pharmaceutical Council (GPhC) should gather information on dispensing errors to make pharmacies safer, a leading academic has said.

The regulator could use evidence it received about dispensing errors to understand why they occurred and help create the "perfect dispensary environment", Hannah Family, lead author of a study into the causes of errors in community pharmacies, told C+D yesterday (September 10).

The study, which was published on Monday (September 8), found that two thirds of community pharmacists and three quarters of pharmacy students failed to detect every dispensing error. Distractions in the pharmacy had a "negative impact" on a pharmacist's ability to detect errors, it said.

In the study, pharmacists and students carried out final accuracy checks on a set of 50 pre-dispensed items, five of which contained errors. Only 35 per cent of community pharmacists and 25 per cent of students were able to detect all of the errors.

Pharmacists were often distracted by assisting patients with "irrelevant tasks" during the dispensing process and it would be helpful if the GPhC used its contact with all pharmacists and technicians to provide more insight into the factors causing dispensing errors, said Ms Family, a lecturer in health psychology at Bath University.

"This might be contentious as [the GPhC] haven't had that role in the past, but it could be good if they supported pharmacists [with] evidence that made their work safer," she added.

The GPhC told C+D that it did not "routinely collate" figures on dispensing errors as this responsibility lay with NHS England, which oversees the National Reporting and Learning System.

The study recommended that pharmacies should prioritise reducing interruptions and distractions in areas where medicines are prepared. This could be done by creating barriers around areas where critical work was being carried out and asking pharmacy staff to avoid interrupting colleagues if they were dispensing a prescription, it said.

Heidi Wright, Royal Pharmaceutical Society practice and policy lead for England, agreed that it would be helpful if the GPhC made use of the evidence it received about dispensing errors, as this information "isn't currently shared".

Pharmacy teams should also be trained about the risks of being distracted, said Ms Wright, who suggested that dispensing processes should be designed to minimise the risk of errors.

The study also showed that pharmacists were more likely to miss labelling errors than errors relating to the wrong type or amount of medicine. However,it did not reveal any correlation between mental workload - the number of tasks an individual is thinking about - and the rate of dispensing errors, the authors concluded.

How common are distractions when you are dispensing? 

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