The Effect of the Unit Dose Dispensing System on Medication Preparation and Administration Errors in Intravenous (IV) Drugs in a Chinese Hospital: Inpatient

Abstract

Intravenous (IV) errors are considered dangerous since IV drugs usually go directly into the patient’s vein. Chinese patients receive more than twice the IVs of all other patients, yet the nature of “medication errors” is understudied. The purpose was to study and test a method for reducing medication errors involving IVs in a Chinese hospital. The objectives were to (1) explore and measure the frequency of medication errors and identify clues to the causes of medication errors in Chinese hospital inpatient units, (2) identify the clinical relevance of the errors, and (3) investigate the effect of a Unit Dose Dispensing System on medication errors involving IV drugs. A General Surgery Patient Ward in a tertiary hospital with more than 1,300 beds in Beijing was selected as a convenience sample. An exploratory study was conducted for 4 weeks. Then a Cluster Randomized Trial design was used for an explanatory study of the effect of installing a Unit Dose Dispensing System. The patients’ doses for the two units on the study ward were randomly assigned to the Control group or the Experimental group by flipping a coin. The direct observation method was used on the day shift from 8 AM to 3 PM to detect medication errors. The preparation and administration processes for Total Parenteral Nutrition (TPN) doses were directly observed by the Principal Investigator for 10 consecutive days for each group, both before and after the Unit Dose Dispensing System was installed in the Experimental group. An Analysis of Covariance (ANCOVA) showed a statistically significant effect on reducing overall medication error rates (F1,17 = 19.77, P = 0.0004), wrong dose error rates (F1,17 = 12.37, P = 0.0026), and omission error rates (F1,17 = 5.52, P = 0.03). The Unit Dose Dispensing System produced a significantly higher accuracy in the preparation and administration of TPN doses.