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'Distractions' in pharmacy contributing to dispensing errors

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Ms Hannbeck: The fear of prosecution over dispensing errors still overshadows pharmacy

Distractions resulting from pharmacists taking on “more and more” work is one of the factors behind dispensing errors reported to the National Pharmacy Association (NPA).

In her latest medication safety officer report, published last month, NPA chief pharmacist Leyla Hannbeck found that “distractions” in the pharmacy are frequently associated with incidents of dispensing errors.

Commenting on the findings, Ms Hannbeck told C+D yesterday (June 5) that “everyone working in a pharmacy is faced with these distractions: the pharmacist is busy checking prescriptions, the phone rings, a staff member is asking questions about what to order, while a patient comes in seeking medical advice”.

A lack of concentration led to one of the incidents highlighted in the report – a child being dispensed methadone instead of a reconstituted antibiotic – which could "have serious consequences", she warned.

Funding cuts increase workload

The NPA advises pharmacists to “do one thing at a time where possible” and “have trained staff who know exactly what they are doing, and are less reliant on a pharmacist’s attention”.

When asked by C+D whether the situation is likely to get worse, as pharmacies in England look to cut staff to try and offset the funding cuts, Ms Hannbeck said: “We’re not trying to say: don’t rely on community pharmacy because they haven’t got enough staff.”

However, “pharmacies need enough funding to make sure they have trained staff to ensure patient safety”.

Fear of prosecution increases errors

Pharmacy staff are “more and more aware of the importance of patient safety and reporting”, Ms Hannbeck said, which she claimed is why the number of error reports the NPA received increased by 45% since the previous report in January.

However, despite the increase in reporting, Ms Hannbeck said the possibility of being prosecuted for an inadvertent dispensing error “still overshadows the profession”.

“This is not helping the profession; pharmacists being nervous affects their mentality. This is not going to help decrease the number of errors,” she said.

Where pharmacists need a “confidence boost”

One area Ms Hannbeck is "keen to look further into" is controlled drugs, as "again this is something that keeps coming up in the [error] reports".

“I don’t think pharmacists are completely confident on the legislation around controlled drugs – we need to boost confidence there,” she added.

12 Comments
Question: 
How often do you make an inadvertent dispensing error?

Jonny Johal, Pharmacy Area manager/ Operations Manager

I can't see how Ms Hannbeck did not associate increased reporting with increased errors. I oppose the decriminalisation of dispensing errors, as I believe that will lead to an increase in errors. As for distractions, I had many since I qualified in 1979, but don't think they caused any of my errors. It would be wrong to say that I didn't work just as hard 35 years ago either.  Subjectively,  I feel that I am seeing more errors (by other pharmacists) in recent years.  

Ian Kemp, Community pharmacist

I have seen many idiotic posts in my time but this one takes the biscuit on a number of levels:

1] If distractions did not contribute to your many errors then what did - sheer incompetence?  I have been qualified a similar length of time and would put the vast majority of my errors [ or failure to spot the errors of others ] down to distractions of some kind.

2] In your capacity as Area Manager you are bound to become aware of more errors if there is increased reporting. I worry for the profession that a pharmacist in a senior, and therefore potentially influential, position is advocating that we go back to sweeping errors under the carpet and praying that nobody finds out let alone learning from errors.

3] In an evidence based profession what evidence can you provide to support your belief that decriminalisation will increase error as opposed to the weighty evidence that shows increased reporting of [ AND LEARNING FROM ] errors has inceased safety in a number of industries

It is symptomatic that Area Managers / owners do not accept that their actions can undermine patient safety. Perhaps we could reach a compromise with the DoH and decriminalise dispensing errors but have mandatory prosecution of Area Managers and above for corporate manslaughter should any error prove to be fatal. That would increase standards at a stroke.

 

Paul Samuels, Community pharmacist

Having been qualified a little longer still-- I fully concur with your observations.

Half the time some PHARMACIST  area managers have detached themselves from its' like to work at the coal face!!

Far too many distractions by both staff & customers have greatly increased due to the pressures put upon us--add in all the extra services & pressure from some area managers it can be become very uncomfortable .

I like the last paragraph--it sums up things perfectly.

Chris Pharmacist, Community pharmacist

10 years ago there weren't MUR, NMS, EPS nomination or private service targets, additional demands regarding Quality payments such as NUMSAS interventions and even targets for using SCR...not to mention ever-rising Rx numbers and medicines sales to satisfy more targets

Undoubtedly staff hours are being cut/staying stagnant to protect profits from government funding cuts, if you think pharmacists now are under no more pressure than 10 years ago then you aren't fit to undertake your role as you are completely ignorant of recent changes in community pharmacy.

Ilove Pharmacy, Non Pharmacist Branch Manager

All the more reason to bring in Robots is what they'll tell you. Good luck.

Chris Locum, Locum pharmacist

No need to state the obvious to the troops in the trenches. Just tell the locum they can't have the phone on because it is a distraction (how come this doesn't apply when staff interrupt you to take a patient phone call).Someone has phoned in sick, so counter not manned and staff have to stop dispensing every so often and...lose the train of thought...

The branch staff said they had to lose 12 hours per week between them. Explain to me how this improves patient safety ?

Eventually more of us will get up and walk away . How how many of us need the incentive of reading about suspended sentences/ being struck off as a scapegoat by GPHC to say enough is enough?

Valentine Trodd, Community pharmacist

'Where pharmacists need a “confidence boost”...'

Will I tell you what would give us a confidence boost? If we knew there wasn't the threat of being locked up for making an honest mistake. This decriminalization thing is a joke at this stage! It seems to be at the bottom of everyones priority list.

The other thing is... the more procedures that are brought in place to name and shame people involved in making errors - error logs, quad stamps, etc. the more we're told there is no blame culture! Yes there is. Let's just acknowledge that - there is a blame culture. I'm not saying it's right or wrong - careless dispensers/pharmacists have no place in the dispensary - but don't keep telling me it's not there!

John Dow, Advertising

This is old news and been happening for years  . People burying their heads in the sand and not shouting loud enough and taking appropropriate action has led to this over many years. Sorry to say, pharmacists are their own worse enemy , frightened to speak out and stand up and be counted but just get on with things and don't cause a fuss. Such a shame .

Andrew Low, Community pharmacist

Well said.There is more and more work coming in and it is taking valuable time away from the basic functions of the dispensary and counter.There are services for example MURS and these have to be done with no extra provision of staff.It is a dangerous situation and more pharmacy staff should speak out like this.Where does the fear not to speak out come from?Is there some lack of confidence in pharmacy?There is so much reticence and diffidence and lack of engagement.

Ilove Pharmacy, Non Pharmacist Branch Manager

I suspect it comes from getting disciplined and then subsequently getting sacked.

Ben Merriman, Community pharmacist

Maybe criminalizing pharmacy staff who make dispensing errors is the plan to further cut community pharmacy numbers...

Leon The Apothecary, Student

Decriminalization would go a long way is encouraging a social change where errors are seen less as potential punishments but opportunities to learn and improve.

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