2010 年 36 巻 1 号 p. 1-9
Various systems for preventing dispensing errors have been developed.Although serious dispensing errors have been reduced by the introduction of these systems,they have not managed to eliminate all dispensing errors in pharmacies since prevention of human error is difficult.Few effective countermeasures have been established due to a lack of information on background factors in reports on dispensing errors and it takes a long time to analyze data if reports are handwritten.We therefore decided to develop a new risk management system to solve these problems.The development of the new system and its effectiveness when used in AIN PHARMACIEZ from October to December in 2008 are described in this report.
The new system has 3 features : citation=1)direct reporting of dispensing errors by staff concerned,citation=2)clear distinction between errors and background factors in reports,and citation=3)simple input by means of multiple choice questions.Direct reporting of a dispensing error by the person responsible for it provides information that others can easily understand and it can be used to evaluate any staff problems.Moreover,the input of both numerical data and background factor information to the database enables organizational problems to be analyzed from various points of view.Such analysis should reveal the limitations of current systems for prevention of dispensing errors and lead to the establishment of effective countermeasures.The newly developed system is therefore expected to contribute greatly to the prevention of dispensing errors in pharmacies.