The PPAQ is a reliable instrument of physical activities during pregnancy.

Comparison of the reviewed studies was confounded by differences in study setting, research method and operational definitions for dispensing errors, error rate and classification of error types. The World Health Organization is currently developing global patient safety taxonomy. Such a standardized taxonomy for dispensing errors would facilitate consistent data collection and assist the development of error-reduction strategies.

The KPAS is a reliable and reasonably accurate instrument for estimating physical activity among pregnant women.

Objective To monitor unprevented dispensing incidents in NHS hospitals by identifying incident types, drugs involved and factors that may have contributed to the occurrence of incidents. Setting All 20 Welsh NHS hospitals (15 district general; 2 teaching; 2 psychiatric and 1 other specialist hospital). Method Unprevented dispensing incidents that occurred between January 2003 and December 2004 were reported and analysed using a validated method. Incident rate was calculated for those hospitals that provided both incident and issue data. Incident rate was compared with previous research using a two‐sample t‐test. Reported incident types and contributory factors were compared with previous research using chi‐square analysis. Key findings A total of 1005 unprevented dispensing incidents were reported by 20 hospitals. The overall incident rate, based on data from 17 hospitals, was 16 incidents per 100000 items dispensed (range 0.2–46 incidents per 100000 items dispensed). The overall dispensing incident rate was less than previously reported (18 incidents per 100000 items dispensed).This finding was not statistically significant (t = 0.421, P = 0.676). The most common incidents reported were dispensing the wrong strength of drug (n = 241, 24%), wrong drug (n = 168, 17%), wrong form (n = 134, 13%) and printing the wrong warnings/directions on the label (n = 112, 11%). A statistically significant finding was that fewer incidents involving dispensing the wrong drug were reported by Welsh hospitals (17%) compared to previous research in the UK (23%; P = 0.01). Drugs most commonly involved in incidents were insulin (n = 34; 6 incidents per 10000 issues of insulin), nifedipine (n = 16; 10 incidents per 10000 issues of nifedipine) and carbamazepine (n = 10; 5 incidents per 10000 issues of carbamazepine). Conclusion The overall unprevented dispensing incident rate was less than previously reported. Dispensing the wrong strength of the correct drug is a problem. Staff should be aware of the risk of dispensing incidents involving insulin, nifedipine and carbamazepine. Strategies for minimising dispensing incidents include using shelf labels to highlight different strengths or formulations of the same drug, and educating staff about easily confused drugs.

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Aims and objectivesThe study aimed to evaluate the causes of prevented dispensing incidents reported by hospitals using the critical incident technique developed by key-informant interviews, focus group and observation. Setting All Welsh NHS hospitals (n = 20) were invited to participate in the study. Sixteen hospitals agreed to take part; 10 hospitals reported incidents, four hospitals did not report any incidents and two hospitals withdrew from the study. Method In June 2005 three key-informant interviews and a focus group were conducted to determine dispensary workflow, which was then validated by a piloted non-participant observational study at three Welsh hospitals. Self-reported critical incident forms were then developed to collect dispensing-incident data involving drugs at high risk of dispensing incidents. Sixteen Welsh hospitals participated in the 4-month study (January-August 2006). Key findings Dispensary workflow encompassed the following events: prescription receipt, validating patient information, log of prescription, technical check, clinical check, label generation, stock selection, medicines assembly, product labelling, completion of registers, self-checking/endorsing and final accuracy check. Twenty-four incidents were reported by 10 hospitals involving paediatrics (n = 9, 38%), morphine sulphate (n = 5, 21%), insulin (n = 5, 21%), angiotensin-converting enzyme inhibitors (n = 3, 13%) and nifedipine (n = 2, 8%). Incidents commonly occurred at label generation (n = 9, 43%) and stock selection (n = 9, 43%), caused by error-producing conditions, active and latent failures. Active failures involved dispensing the wrong quantity of medication, interchanging different formulations, and computer and stock-selection errors. Error-producing conditions were reported as high workload, complex prescriptions and interruptions. Latent conditions were inadequate staffing/ skill mix, unclear drug computer selection lists and the storage of drugs on dispensary shelves. Conclusion The critical incident technique provided an in-depth understanding of the causes of dispensing incidents. Dispensing incidents arose because of organisational pathologies, error producing conditions and active failures such as inadequate staffing, high workload, interruptions, and computer and drug-selection errors.Patient safety is of major importance to the pharmacy profession and central to this is the minimisation of dispensing incidents. Unprevented dispensing incidents, detected and reported after the medication has left the pharmacy, occur relatively infrequently at a rate of 16-18 per 100000 items dispensed in UK hospitals. [1][2][3][4] In contrast, prevented dispensing incidents identified during the dispensing process before medication has left the pharmacy occur more frequently, at a rate of 0.94-2.1% in UK hospitals. 1,5,6 Despite the low incidence, dispensing incidents, if undetected, can cause serious patient harm, morbidity and occasionally death. 7-9 Thus it is imperative that the dispensing incidents are reviewed so ...

Study findings suggest that automation improves dispensing efficiency and reduces the rate of prevented dispensing incidents. It is proposed that prevented dispensing incidents frequently occurred during periods of high workload due to involuntary automaticity. Prevented dispensing incidents occurring after a busy period were attributed to staff experiencing fatigue after-effects.