I wondered if anyone could help me. I keep make dispensing errors. All of these have been the wrong strengths of drugs and have been reaching the patient. Ive already made 3 this year and im worried of been struck off.
I dont know what im doing wrong. I try to always tick the name, strength and form on the box of im dispensing to insure its right. I know the mistakes are happening when im rushing as well. My company has rules in regards to notifying them of mistakes and i have been doing so. I also know these mistakes are out of nearly 20k items ive checked this year. But idnt want to excuse this i really want to stop this now.
Are you working alone? Is there no one to double check your work? If there isn't another pharmacist or a technician ask a counter hand. If they can read they can see an obvious error. We all make mistakes but a second pair of eyes usually spots them before they get to the patient.
You have already noticed that you make the mistakes when you are rushing so the obvious answer is to slow down. I know it's easier said than done but you have to take control and set the pace you can work safely at. Some people dispense faster than others but they don't always get more done. There is an old saying "more haste, less speed" and that is worth remembering when you are tempted to work at haste.
Worrying about making mistakes and about getting struck off is a sure way of being distracted and making even more mistakes so instead of beating yourself up about this get help.
It sounds as though you are having a stressful time at work. So many of us are finding ourselves in such situations. Some handle the hassles better than others though. I'm assuming you are a Pharmacist.
Are you on your own?
If so, are you in a position to request a Tech or Dispenser?
Are you working for a large multiple or independant?
And are you taking your required breaks???
Its sounds to me as though you really need some help. You have to ask for it as maybe your bosses think that you are coping ok.....
The company I work for have started a 'third check' policy - whereby upon issue, a bagged Rx is opened, it's contents checked (forms, strengths and quantities in the main, I don't think checking labels is a requirement) and the person performing the check then signs the script to say it has had a third check... As a student, it terrifies me to have such responsibility, but it has prevented many mistakes being made/issued, so perhaps is a good idea. I doubt this will become standard across the board though, even though I do work for a multiple...
easy way is, make sure YOU have control of the dispensing area and not your dispensers, I do this as a locum, even if they say "we dispense here", not when i'm there. I have atleast a yards working space infront of me where all I have is the Rx i'm dispensing/checking with all the needed accessories in easy reach.
I agree with SolomonQ. My working area has to be 'tidy' and it is all mine. If you want me to make mistakes, all you have to do is clutter my work space. I also teach my dispensers and Pre-Reg students this trick. It avoids the possibility of drugs from another script being included during the bagging stage, etc. Also when I check I ensure that the excess stock is removed the moment the relevant drug has been checked. It once happened when I asked the dispenser trainee to bag what I had checked and the tub of Diazepam 5mg reached the patient!
A few tips that has helped me through the years:
1. Ensure that you do use vestibules. Get different sizes and also different colours. Different sizes speak for itself, but the different colours could help you prioritize.
2. Look at the flow of your dispensing work. This is more difficult because, like johnep mentions, some dispensaries just do not have the space.
3. Currently I find myself with only a Healthcare Assistant from 5pm through 6pm. I have taken the plunge in exposing the HCA to the checking process. She has taken to it like a duck to water, and even if there are times when she can not help, eg hand written Rx, she still is invaluable in making sure that the name on the Rx matches the name on the box and label. She also count check all CD's I am called to dispense during that last hour of the day.
I know there will be those that will shoot me for the last piece of advise, but I am reminded of a saying: 'It is not what you have got, but rather what you do with what you have got.'
Lastly I wholeheartedly underscore Hibernia's statement - worrying about making mistakes and beating yourself up while you are working is not going to put you in the right frame of mind. You are going to make mistakes, we all do, but the important bit is to learn from them, put measures in place and move on striving to always do your best. Remember, always make new mistakes.
PS just a last thought. If you are privileged to work with some really good locums, learn from them. I have over the years realized that the good locums learn tricks from the various places they work at and become real fountains of knowledge (tricks) - I personally have picked up quite a few from them.
My mistakes seem to be not writing CD drugs into the CD register - which is getting annoying, as I try to, but sometimes when there is a call back, its given out and the Rx is not given back to me, or the other pharmacist forgets to put it in. Of course, I'm the locum so it gets blamed on me. But what do you guys do for this kind of thing?
Put a note on a piece of paper into correct page of register to remind you. Check the register each day. I have had this happen to me where scripts just been put through without an entry. Where register does not correspond to stock, then Pharmacy Manager can give a dispensed item report.
Once I had to make an entry several weeks later. Also, when dispense CD put note onto bag for script to be handed to pharmacist.
johnep
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