Background: Dispensing medication is a chain of multiple stages, and any error during the dispensing process may cause potential or actual risk for the patient. Few research studies have investigated the nature and contributory factors associated with dispensing errors in hospital pharmacies. Aim: To determine the nature and severity of dispensing errors reported in the hospital pharmacies at King Saud Medical City (KSMC) hospital in Saudi Arabia, and at Luton and Dunstable University Hospital (L&D) NHS Foundation Trust in the UK; and to explore the pharmacy staff perceptions of contributory factors to dispensing errors and strategies to reduce these errors. Materials and Methods: A mixed method approach was used and encompassed two phases. Phase I: A retrospective review of dispensing error reports for an 18-month period at the two hospitals. The potential clinical significance of unprevented dispensing errors was assessed. Data was analysed using descriptive statistics in SPSS and A Fisher's test was used to compare the findings. Phase II: Self-administered qualitative questionnaires (open-ended questions) were distributed to the dispensary teams in KSMC and L&D hospitals. Content analysis was applied to the qualitative data using NVivo qualitative analysis software. Result: Dispensing the wrong medicine or the incorrect strength were the most common dispensing error types in both hospitals. Labelling errors were also common at the L&D pharmacy dispensary. The majority of the unprevented dispensing errors were assessed to have minor or moderate potential harm to patients. Look-alike/sound-alike medicines, high workload, lack of staff experience, fatigue and loss of concentration during work, hurrying through tasks and distraction in the dispensary were the most common contributory factors suggested. Ambiguity of the prescriptions was a specified factor in the L&D pharmacy, while poor pharmacy design and unstructured dispensing process were specified contributory factors in the KSMC pharmacy. Conclusions: Decreasing distractions and enhancing the pharmacy design and the dispensing workflow are necessary to reduce dispensing errors. Furthermore, monitoring and reporting errors and educating the dispensary team about these errors is also needed. Automation and e-prescribing systems may improve dispensing efficiency and safety. The findings of this study reemphasise the fact that dispensing errors are prevalent in hospital pharmacies. Efficient interventions need to be implemented to mitigate these errors.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Adviser: Charles E. Begley. Includes bibliographical references.

Objective: The primary objective of the thesis is to advance proactive thinking in designing healthcare facilities for safety by constructing theory to bridge gaps between evidence-based design (EBD) and human factors/ergonomics (HF/E). Background: Adverse events are a pervasive issue in healthcare, with causes and prevention measures under increased scrutiny for the past 15 years. The physical environment can be an underlying condition of safety and healthcare (HC) facility design can be seen as a layer of defense in accident causation theory. However, HC facility design is complicated and complex, and the implications of decisions can be felt for decades. While architects excel at problem solving, they are not fully versed in healthcare work tasks, flow, and function, resulting in complex system interactions. Evidence-based design (EBD) is a process that uses research as a foundation for decision-making in HC facility design. While the EBD process acknowledges the importance of system factors, its focus is on understanding specific facility design interventions on outcomes such as safety, efficiency, quality of care, and satisfaction. HF/E focuses on humans interacting with a system with a goal of optimizing human well-being and overall system performance. Although HF/E recognizes the physical environment as a system component, the ergonomic definition of the environment lacks clarity and influences are frequently considered at a microergonomic level. In summary, EBD supports desired outcomes of a system through building design, while HF/E more often supports desired outcomes of the system through work design. Methods: The thesis leverages a grant to create a Safety Risk Assessment (SRA) toolkit for HC facility design using: (1) consensus-based methods to develop built-environment considerations for falls in HC facility design, (2) a mixed methods approach to test the SRA in hypothetical scenarios, (3) a mixed methods approach to test the SRA in real-world scenarios, (4) quantitative and qualitative analysis using an inductive and abductive approach to construct grounded theory to develop a core theme and a theoretical framework for proactively considering safety in HC facility design, (5) an extended systematic literature review to identify additional system considerations of the organization and people, and (6) established thinking to advance new theoretical frameworks to achieve the thesis objectives. Results: Two theoretical frameworks are proposed. The first framework, Safety as Complexity of the Organization, People and Environment (SCOPE) is based on the Dial-F systems model (Hignett 2013). The evolution includes: the definition of the ergonomic environment using building design as the most stable element of the system, identifying built environment interventions to mitigate the risk of falls (SCOPE 1.0); the addition of non-building design interventions of the system such as organizational and people-based conditions (SCOPE 2.0); and the integration of HF/E design principles to reframe thinking about hospital falls (DEEP SCOPE). The second framework evolves from grounded theory constructed through data from SRA testing proposing safe design as a participatory process to anticipate, participate, and integrate solutions. A participatory ergonomics framework (Haines and Wilson 1998) is integrated with a mesoergonomic framework of inquiry (Karsh, Waterson, and Holden 2014, Karsh 2006) to advance a theoretical framework of participatory mesoergonomics using the SRA and SCOPE content as inputs over the course of a HC facility design project to achieve safety. Conclusion: The gap between EBD and HF/E can be bridged using safety (falls) as a proactive consideration during HC facility design using theoretical frameworks. These frameworks address (1) the definition of building design and design considerations in the HF/E context and (2) integration of the EBD process with HF/E methods to understand interactions of the system.

Human life is affected by illness and the loss of self-sufficiency. The aim of social work in hospitals is to help clients and their families come to terms with the problems associated with illness and to restrict and eliminate these problems. The theoretical part of the paper looks at health and illness, the needs people in hospital have, the changes that come about in the course of illness and illnesses as social events. I also look at social work in hospitals, the work of health/social workers and the theories and methods that are applied to social work in hospitals. The aim of the paper is to map out the influence of social work in hospitals on the health of patients. The main research question set out was, in what way does social work in hospitals influence the health of patients? In order to answer this question, I asked the following sub-questions: 1. What influence does social work in hospitals have on the physical side of the health of patients/clients? 2. What influence does social work in hospitals have on the mental side of the health of patients/clients? 3. What influence does social work in hospitals have on the social situation of patients/clients? 4. What methods or techniques of social work are used in social work at hospitals? The strategy of qualitative research was used to achieve the objectives set out. Questioning in the form of a semi-structured interview was the method chosen for obtaining information and questioning was supplemented by the method of monitoring. Interviews were conducted with 6 health/social workers and 15 clients/patients of such health/social workers. This paper could contribute towards an improvement in the social work services provided in hospitals and may also serve to broaden the knowledge level of the general and expert public.

Project (B.S.)--James Madison University, 2009. / Includes bibliographical references.