Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study.
OBJECTIVE
The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADCs on medication selection and preparation error rates in EDs. Our aim was to assess the impact of ADCs on medication selection and preparation error rates in an ED of a tertiary teaching hospital.


METHODS
Pre intervention and post intervention study involving direct observations of nurses completing medication selection and preparation activities before and after the implementation of ADCs in the original and new emergency departments within a 377-bed tertiary teaching hospital in Australia. Medication selection and preparation error rates were calculated and compared between these two periods. Secondary end points included the impact on medication error type and severity.


RESULTS
A total of 2087 medication selection and preparations were observed among 808 patients pre and post intervention. Implementation of ADCs in the new ED resulted in a 64.7% (1.96% versus 0.69%, respectively, P = 0.017) reduction in medication selection and preparation errors. All medication error types were reduced in the post intervention study period. There was an insignificant impact on medication error severity as all errors detected were categorised as minor.


CONCLUSIONS
The implementation of ADCs could reduce medication selection and preparation errors and improve medication safety in an ED setting.
Pharmacy Department, Eastern Health, Box Hill, Victoria, Australia.
Laura
L
Fanning
Pharmacy Department, Eastern Health, Box Hill, Victoria, Australia.
Nick
N
Jones
School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.|Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.|Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia.
Elizabeth
E
Manias
D001315:Australia; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data*; D005260:Female; D006784:Hospitals, Teaching / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000145:classification / Q000517:prevention & control* / Q000706:statistics & numerical data*; D008510:Medication Systems, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data*; D008875:Middle Aged; D011446:Prospective Studies
automation; emergency service; hospital; medication errors; medication systems; patient safety