The study of preparing errors by pharmacy robot and various electronic drug cabinet in hospitalized patients at Srinagarind Hospital

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Piangpen Chanatepaporn


Medication errors can cause a harmful treatment to patients. Objective: To compare rate, severity level, type and causal factors of preparing errors between Pharmacy robot, Semi-Automatic Medication Dispenser Station (LED cabinet), High alert drug Medication Cabinet (HAD cabinet) and manual picking in hospitalized patients. Method: This study was a retrospective descriptive study. Reports of predispensing and dispensing errors in wrong preparing process were collected in inpatients pharmacy service unit at Srinagarind Hospital by pharmacists and medical staffs. Data were collected between 1st July 2018 and 30th June 2019. The data for causal factors were collected by using fishbone diagram from brainstorming results. Results: Medication were prepared by pharmacy robot 255,969 items, LED cabinet 711,313 items, HAD cabinet 42,632 items and manual picking 1,137,194 items. The pharmacy robot had the least incidence of preparing errors, followed by HAD cabinet, LED cabinet and manual picking (0.63, 1.17, 7.54 and 9.16 errors per 10,000 prescriptions), respectively. Incidence rate of preparing errors were statistical difference (p < 0.001); pharmacy robot had 1,355.24% error less than manual picking, pharmacy robot had 1,096.83% error less than LED cabinet. However, the pharmacy robot was less error than HAD cabinet 87% with no statistical significance. The severities of preparing errors were found statistical difference only in level B. (p < 0.001). The type of preparing errors by manual picking and LED cabinet were wrong drug, strength, dosage form, amount, person, lacking of medicine and swapping of medicine bag. Pharmacy robot and HAD cabinet found only wrong drug and amount. The product defected were found only in pharmacy robot. Human errors and drug factors were the most effect for preparing errors in manual picking, especially the drug which have look alike and sound alike. Prescription and drug label factor were the most effects for preparing errors in LED cabinet. Equipment factor was the most effect for preparing errors in pharmacy robot and LED cabinet. Conclusion: The pharmacy robot caused the least incidence of preparing errors, followed by HAD cabinet, LED cabinet and manual picking in hospitalized patients. Hence, the technology can be come an essential tool to reduce the cause of human error and  look-alike sound-alike problems.


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Pharmaceutical Practice


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