A novel device to prevent errors in medication dosing and dispensing

The movement of syringes and medication during anesthesiology delivery: An observational study in laparoscopic surgeries

The movements of syringes and medications during an anesthetic case have yet to be systematically documented. We examine how syringes and medication move through the anesthesia work area during a case. We conducted a video-based observational study of 14 laparoscopic surgeries. We defined 'syringe events' as when syringe was picked up and moved. Medications were administered to the patient in only 48 (23.6%) of the 203 medication or syringe events. On average, 14.5 syringe movements occurred in each case. We estimate approximately 4.2 syringe movements for each medication administration. When a medication was administered to the patient (either through the IV pump or the patient port), it was picked up from one of 8 locations in the work area. Our study suggests that the syringe storage locations vary and include irregular locations (e.g., patient bed or provider's pockets). Our study contributes to understanding the complexity in the anesthesia work practices.

Assessment of Medication Errors Among Anesthesia Clinicians in Saudi Arabia: A Cross-Sectional Survey Study

Introduction

Anesthetic drugs are prepared and administrated without referral to the pharmacy or other medical departments. We aimed to assess the occurrence of anesthetic drug errors in Saudi Arabia. We also determined the contributing factors, reporting strategies, and clinicians' opinions of the preventive measures.

Methods

We conducted a cross-sectional web-based survey study using a validated tool. A total of 300 anesthesia clinicians completed the survey (146 anesthesiologists and 154 anesthesia technology specialists). We measured descriptive statistics to describe the demographic characteristics and performed inferential statistics to examine associations and differences.

Results

Sixty-nine percent of respondents had experienced an anesthetic drug error at least once in their career. The two primary factors that caused drug errors were haste (60.3%) and heavy workload (60.3%). On syringe labeling, 56.3% withdrew the drug then labeled the syringe, and 43.7% labeled the syringe then withdrew the drug. The chi-square test revealed that clinicians who labeled the syringe first then withdrew the drug made errors more frequently (p = 0.036). The test also showed that clinicians with less experience had committed more errors (p = 0.015). On reporting drug errors, 77.7% of respondents identified the fear of medicolegal issues as the most common barrier to reporting errors. Respondents believed that double-checking the medication and color-coded syringe labels were the most effective strategies to reduce errors (82% and 64%, respectively). The Mann-Whiney U test revealed significant differences between the two specialties about their opinions of the preventive measures.

Conclusions

There was a high occurrence rate of anesthetic drug errors in Saudi Arabia. Policymakers need to unify the syringe-labeling practice, and future research needs to focus on what makes a nonpunitive culture to encourage reporting errors.