title: Automated drug dispensing system reduces medication errors in an intensive care setting.
abstract: OBJECTIVE
  We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction.
  
  
  METHODS
  Preintervention and postintervention study involving a control and an intervention medical intensive care unit.
  
  
  METHODS
  Two medical intensive care units in the same department of a 2,000-bed university hospital.
  
  
  METHODS
  Adult medical intensive care patients.
  
  
  METHODS
  After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control.
  
  
  RESULTS
  The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; p<.05); however, no significant difference was observed before automated dispensing system implementation (20.4% and 19.3%, respectively; not significant). Before-and-after comparisons in the study unit also showed a significantly reduced percentage of total opportunities for error (20.4% and 13.5%; p<.01). An analysis of detailed opportunities for error showed a significant impact of the automated dispensing system in reducing preparation errors (p<.05). Most errors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale.
  
  
  CONCLUSIONS
  The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.
authors.affiliation: Pharmacy Department, Grenoble University Hospital, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Chapuis
authors.forename: Matthieu
authors.initials: M
authors.lastname: Roustit
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Bal
authors.forename: Carole
authors.initials: C
authors.lastname: Schwebel
authors.forename: Pascal
authors.initials: P
authors.lastname: Pansu
authors.forename: Sandra
authors.initials: S
authors.lastname: David-Tchouda
authors.forename: Luc
authors.initials: L
authors.lastname: Foroni
authors.forename: Jean
authors.initials: J
authors.lastname: Calop
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Timsit
authors.forename: Benoît
authors.initials: B
authors.lastname: Allenet
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bosson
authors.forename: Pierrick
authors.initials: P
authors.lastname: Bedouch
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation; D003422:Critical Care / Q000592:standards / Q000639:trends; D004334:Drug Administration Schedule; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D015397:Program Evaluation; D012016:Reference Values; D011795:Surveys and Questionnaires; D017749:Total Quality Management
chemical_list: D004364:Pharmaceutical Preparations