A Comparison of Medication Errors Under the University of Kentucky Unit Dose System and Traditional Drug Distribution Systems in Four Hospitals

Abstract

The University of Kentucky Hospital has operated a hospital-wide unit dose system of dispensing medications for more than 4 years. 2 community and 2 university hospitals still using the traditional medication systems were used in a comparative study to ascertain which system leads to more medication errors. The criteria for hospital selection are discussed. Medication error audits were performed on selected medical nursing units in each of the 5 hospitals in the study. The auditing methodology is described. Medication errors which were measured included dosage errors timing errors and omissions of medication. The University of Kentucky Hospital was found to have a statistically significantly lower total error rate combining errors of omission and errors of commission. The 4 hospitals chosen for comparative purposes differed among themselves in the number and type of errors found. Information handling was found to be a major source of drug error. At the University of Kentucky Hospital the pharmacists were found to play an active role in the drug distribution process as opposed to the other hospitals where the pharmacists were relegated to a superficial role.