Impact of interruptions and distractions on dispensing errors in an ambulatory care pharmacy

A possible association between interruptions and distractions and the occur rence of dispensing errors was investigated. Fourteen pharmacists and 10 technicians in an ambulatory care pharmacy at a general medical-surgical hospital were tested for distractibility by using the group embedded figures test (GEFT) as well as for visual acuity and he aring. They were videotaped as they filled prescriptions during a 23-day pe riod in 1992. A study investigator compared each filled prescription with t he physician's written order, noted details of deviations, verified with th e pharmacist any errors that occurred,and asked the pharmacist to correct t he error if necessary. Interruptions and distractions were detected and cha racterized by reviewing the videotapes. None of the study participants had significant hearing or visual impairment . There was a significant association between GEFT scores and error rates, A total of 5072 prescriptions were analyzed, and 164 errors were detected, for an overall error rate of 3.23%. Wrong label information was the most co mmon type of error (80% of errors detected). A total of 2022 interruptions (mean +/- S.D, per half hour per subject, 2.99 +/- 2.70) and 2457 distracti ons (mean +/- S.D. per half hour per subject, 3.80 +/- 3.17) were detected. The error rate for sets of prescriptions with one or more interruptions wa s 6.65% and for sets during which there were one or more distractions, 6.55 %. Interruptions and distractions per half hour were both significantly ass ociated with errors. In an ambulatory care pharmacy, interruptions and distractions over a half- hour period were associated with dispensing errors, a majority of which inv olved incorrect label information.