Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;26(10):817-823.
doi: 10.1136/bmjqs-2016-006422. Epub 2017 Apr 21.

Safety and efficiency of a new generic package labelling: a before and after study in a simulated setting

Beate Hennie Garcia  1   2 , Renate Elenjord  2 , Camilla Bjornstad  2 , Kjell Hermann Halvorsen  1 , Sigurd Hortemo  3 , Steinar Madsen  3
Affiliations

Safety and efficiency of a new generic package labelling: a before and after study in a simulated setting

Beate Hennie Garcia et al. BMJ Qual Saf. 2017 Oct.

Abstract

Background: Medication errors are frequent and may cause harm to patients and increase healthcare expenses.

Aim: To explore whether a new labelling influences time and errors when preparing medications in accordance with medication charts in an experimental setting.

Method: We carried out an uncontrolled before and after study with 3 months inbetween experiments. Phase I used original labelling and phase II used new generic labelling. We set up an experimental medicine room, simulating a real-life setting. Twenty-five nurses and ten pharmacy technicians participated in the study. We asked them to prepare medications in accordance with medication charts, place packages on a desk and document the package prepared. We timed the operation. Participants were asked to prepare medications in accordance with as many charts as possible within 30 min.

Results: Nurses prepared significantly more medication charts with the generic labelling compared with the original 3.3 versus 2.6 (p=0.009). Mean time per medication chart was significantly lower with the generic labelling 6.9 min/chart versus 8.5 min/chart (p<0.001). Pharmacy technicians were significantly faster than the nurses in both phase I (6.8 min/chart vs 9.5 min/chart; p<0.001) and phase II (6.1 min/chart vs 7.2 min/chart; p=0.013). The number of errors was low and not significantly different between the two labellings, with errors affecting 9.1% of charts in phase I versus 6.5% in phase II (p=0.5).

Conclusions: A new labelling of medication packages with prominent placement of the active substance(s) and strength(s) in the front of the medication package may reduce time for nurses when preparing medications, without increasing medication errors.

Keywords: Hospital medicine; Medical error, measurement/epidemiology; Medication safety; Nurses; Patient safety.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
New structured labelling as suggested by Endestad et al.
Figure 2
Figure 2
Experimental procedure in a simulated medicine room. *n represent the number of medication charts the participant was able to prepare during the allocated time.
Figure 3
Figure 3
Mean time (minutes) per medication chart when preparing medications in accordance with medication charts in phase I (original labelling) and phase II (generic labelling).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. National Coordinating Council for Medication Error Reporting and Prevention. About medication errors—what is a medication error? 2016 [cited 2016 11.21]. http://www.nccmerp.org/about-medication-errors
    1. Tam VC, Knowles SR, Cornish PL, et al. . Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. CMAJ 2005;173:510–5. 10.1503/cmaj.045311 - DOI - PMC - PubMed
    1. de Vries EN, Ramrattan MA, Smorenburg SM, et al. . The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care 2008;17:216–23. 10.1136/qshc.2007.023622 - DOI - PMC - PubMed
    1. Berman A. Reducing medication errors through naming, labeling, and packaging. J Med Syst 2004;28:9–29. - PubMed
    1. World Health Organization. Patient safety—Data and statistics [cited 2016 11.21]. http://www.euro.who.int/en/health-topics/Health-systems/patient-safety/d...