Background and importance High patient safety is a top priority in healthcare systems worldwide. To secure high patient safety, previous research have focused on different medication concepts (eg, automatic medication dispensing, nurse led medication dispensing or self-administration by patients). However, resources are scarce and decision makers want the most ‘value for money’. Therefore, hospital managers investigated the patient safety of medication dispensing performed by pharmaconomists (pharmacy technician with a 3 year degree (180 European credit transfer system points)) compared with nurses.
Aim and objectives To evaluate patient safety of ward level medication dispensing performed by pharmaconomists compared with nurse led medication dispensing.
Material and methods Medication dispensing by pharmaconomists was implemented at seven hospital wards in January 2020. The study was designed as a before and after study. The proportion of ward level dispensing errors was collected through disguised observation of nurses and pharmaconomists in the medicine room before and after implementation of pharmaconomist led medication dispensing. Before data (control group) stem from a PhD study (by the main author) at the same hospital. These data were collected in 2017–2018 by observing 37 nurses in one ward. After data (intervention group) were collected in March and June 2020. After data were collected in seven wards, to increase the number of pharmaconomists observed (9 instead of only 1) and thus increase generalisability. The collection of after data was performed over two periods due to COVID-19 restrictions at the hospital. A dispensing error was defined as a deviation between the prescription and the dispensed medication (eg, wrong dose). Opportunity for errors (OEs) was defined as any medication dispensed and any medication prescribed but not dispensed. Dispensing error proportion=(dispensing errors/OEs) × 100%.
Results In the control group (before data), 1028 OEs were observed, covering 120 patients. In the intervention group (after data), 1036 OEs were observed, covering 122 patients. The dispensing error proportion was 2.2% (95% CI 1.4 to 3.3%) in the intervention group (23 errors) compared with 12.8% (95% CI 10.9 to 15.0) in the control group (132 errors). The difference between groups was statistically significant (p=0.00).
Conclusion and relevance As pharmaconomists made fewer dispensing errors compared with nurse led medication dispensing, the results indicate high patient safety when medication is dispensed by pharmaconomists. Medication dispensing by pharmaconomists may therefore be a safe alternative to nurse led medication dispensing.
Conflict of interest No conflict of interest