Publications
270 results found
Ghaleb MA, Barber N, Franklin BD, et al., 2010, The incidence and nature of prescribing and medication administration errors in paediatric inpatients, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 95, Pages: 113-118, ISSN: 0003-9888
- Author Web Link
- Cite
- Citations: 175
Reynolds M, McLeod M, Mounsey A, et al., 2010, A simulation study of two hospital pharmacy dispensary systems, Pages: 266-268
In this paper we present the preliminary findings of a discrete event simulation study of two hospital pharmacy dispensary systems. In close collaboration with service managers and other pharmacists, we studied the out-patient prescription dispensing systems of Charing Cross and Hammersmith Hospitals, both part of Imperial College Healthcare NHS Trust. Having established the face validity of the model, we estimated the likely impact of changes in prescription workload in terms of mean turnaround times and proportion of prescriptions completed within 45 minutes. Finally, we sought to investigate the likely impact on the same metrics of removing the strict first-in first-out policy of handing out prescriptions to patients in one of the two hospitals. Contrary to expectations, the simulations suggest that removing such rule will most likely not result in a markedly improved service performance.
Shebl NA, Dean Franklin B, Barber N, 2010, Failure mode effect analysis (FMEA): What do hospital staff in the United Kingdom think of it?, Pages: 30-31, ISSN: 0961-7671
- Cite
- Citations: 1
Vats A, Vashist D, Franklin BD, et al., 2010, Equipment and technology problems in operating theatres - a disease of the surgical system, Electronic Poster of Distinction in Association-of-Surgeons-of-Great-Britain-and-Ireland-International-Surgical-Congress, Publisher: WILEY-BLACKWELL, Pages: 152-152, ISSN: 0007-1323
Cornford T, Savage I, Jani Y, et al., 2010, Learning lessons from electronic prescribing implementations in secondary care, MEDINFO 2010, PTS I AND II, Vol: 160, Pages: 233-237, ISSN: 0926-9630
- Author Web Link
- Cite
- Citations: 2
Franklin BD, McLeod M, Barber N, 2010, Comment on 'Prevalence, Incidence and Nature of Prescribing Errors in Hospital Inpatients: A Systematic Review', DRUG SAFETY, Vol: 33, Pages: 163-165, ISSN: 0114-5916
- Author Web Link
- Cite
- Citations: 7
Franklin BD, Birch S, Savage I, et al., 2009, Methodological variability in detecting prescribing errors and consequences for the evaluation of interventions, PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Vol: 18, Pages: 992-999, ISSN: 1053-8569
- Author Web Link
- Cite
- Citations: 37
Barber ND, Alldred DP, Raynor DK, et al., 2009, Care homes' use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people, QUALITY & SAFETY IN HEALTH CARE, Vol: 18, Pages: 341-346, ISSN: 1475-3898
- Author Web Link
- Cite
- Citations: 173
Barber ND, Alldred DP, Raynor DK, et al., 2009, Care homes' use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people., Qual Saf Health Care, Vol: 18, Pages: 341-346
INTRODUCTION: Care home residents are at particular risk from medication errors, and our objective was to determine the prevalence and potential harm of prescribing, monitoring, dispensing and administration errors in UK care homes, and to identify their causes. METHODS: A prospective study of a random sample of residents within a purposive sample of homes in three areas. Errors were identified by patient interview, note review, observation of practice and examination of dispensed items. Causes were understood by observation and from theoretically framed interviews with home staff, doctors and pharmacists. Potential harm from errors was assessed by expert judgement. RESULTS: The 256 residents recruited in 55 homes were taking a mean of 8.0 medicines. One hundred and seventy-eight (69.5%) of residents had one or more errors. The mean number per resident was 1.9 errors. The mean potential harm from prescribing, monitoring, administration and dispensing errors was 2.6, 3.7, 2.1 and 2.0 (0 = no harm, 10 = death), respectively. Contributing factors from the 89 interviews included doctors who were not accessible, did not know the residents and lacked information in homes when prescribing; home staff's high workload, lack of medicines training and drug round interruptions; lack of team work among home, practice and pharmacy; inefficient ordering systems; inaccurate medicine records and prevalence of verbal communication; and difficult to fill (and check) medication administration systems. CONCLUSIONS: That two thirds of residents were exposed to one or more medication errors is of concern. The will to improve exists, but there is a lack of overall responsibility. Action is required from all concerned.
Shebl NA, Franklin BD, Barber N, 2009, Is failure mode and effect analysis reliable?, J Patient Saf, Vol: 5, Pages: 86-94
OBJECTIVE: To test the reliability of failure mode and effect analysis (FMEA) within a hospital setting in the United Kingdom. METHODS: Two multidisciplinary groups were recruited, within 2 hospitals from the same National Health Services (NHS) Trust, to conduct separate FMEAs in parallel on the same topic. Each group conducted an FMEA for the use of vancomycin and gentamicin. The groups followed the basic FMEA steps, which included mapping the process of care; identifying potential failures within the process; determining the severity, probability, and detectability scores for these failures; and finally making recommendations to decrease these failures. RESULTS: Both groups described the process with 5 major steps: starting vancomycin or gentamicin, prescribing the antibiotics, administering the antibiotics, monitoring the antibiotics, and finally stopping or continuing the treatment. Although each group identified 50 failures, only 17 (17%) of them were common to both. Furthermore, the severity, detectability, and risk priority number scores for both groups differed markedly resulting in their failures being prioritized differently. CONCLUSIONS: Failure mode and effect analysis is a useful tool to aid multidisciplinary groups in understanding a process of care and identifying errors that may occur. However, the results of this study call into question the reliability of the FMEA process that was tested. The 2 groups identified similar steps in the process of care but different potential failures with very different risk priority numbers. Such discrepancies make it impossible to identify reliably those failures that should be prioritized and thus where money, time, and effort should be allocated to avoid these failures. Health care organizations should not solely depend on FMEA findings to improve patient safety.
Franklin BD, Taxis K, Barber N, 2009, <i>Parenteral drug errors</i> Reported error rates are likely to be underestimation, BRITISH MEDICAL JOURNAL, Vol: 338, ISSN: 0959-8146
- Author Web Link
- Cite
- Citations: 13
Franklin BD, Rei MJ, Barber N, 2009, Dispensing errors., Int J Pharm Pract, Vol: 17, Pages: 7-8, ISSN: 0961-7671
Franklin BD, Jacklin A, Barber N, 2008, The impact of an electronic prescribing and administration system on the safety and quality of medication administration, International Journal of Pharmacy Practice, Vol: 16, Pages: 375-379, ISSN: 0961-7671
Objective: To assess the effect of an electronic prescribing and administration system on the safety and quality of medication administration in a UK hospital. Setting: Surgical ward in a teaching hospital. Method: Data were collected before and after introducing a closed-loop system comprising electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration records (ServeRx, MDG Medical). We observed medication administration during drug rounds and assessed medication administration error (MAE) rates for ward-stock and non-ward-stock drugs, accuracy of medication administration documentation, timeliness of administration, administration of medication from unlocked areas and supervision of patients taking oral medication by nursing staff. Key findings: Pre- and post-intervention MAE rates were 6.4 and 2.3% respectively for ward-stock drugs (95% confidence interval for the difference (CI) -5.8 to -2.4%), and 14.6 and 13.7% for non-ward-stock drugs (CI -6.5 to 4.7%). Excluding omissions due to unavailability, pre- and post-intervention MAE rates were 6.2 and 2.2% respectively for ward-stock drugs (CI -5.7 to -2.3%), and 9.2 and 3.5% for non-ward-stock drugs (CI -9.3 to -2.1 %). Pre-intervention, 2086 doses (96.3%) were documented correctly and 1557 (95.9%) post-intervention (CI -1.6 to 0.8%). There were five clinically significant documentation discrepancies pre-intervention (0.2%), and 33 (2.0%) afterwards (CI 1.1 to 2.5%). Timeliness of administration improved post-intervention (P < 0.001; Chi-square test), as did administration of medication from unlocked areas (CI 4.7 to 7.3%) and supervision of patients taking oral medication (CI 17 to 23%). Conclusion: Reductions in MAEs, excluding omissions due to unavailability, occurred for both ward-stock and non-ward-stock drugs. The system also improved timeliness and security of drug administration. However, there was an increase in potentially significant documentat
Mounsey A, Franklin BD, Langfield B, 2008, Automated CD management - Its introduction in a UK hospital pharmacy, Hospital Pharmacist, Vol: 15, Pages: 424-428, ISSN: 1352-7967
- Cite
- Citations: 1
Franklin BD, Parr J, 2008, Development and evaluation of a medication incidents briefing seminar, PHARMACY WORLD & SCIENCE, Vol: 30, Pages: 957-958, ISSN: 0928-1231
Vincent C, Aylin P, Franklin BD, et al., 2008, Is health care getting safer?, BRITISH MEDICAL JOURNAL, Vol: 337, ISSN: 0959-8146
- Author Web Link
- Open Access Link
- Cite
- Citations: 116
Alldred DP, Standage C, Zermansky AG, et al., 2008, Development and validation of criteria to identify medication-monitoring errors in care home residents, International Journal of Pharmacy Practice, Vol: 16, Pages: 317-323, ISSN: 0961-7671
Aim: The identification of medication-monitoring errors requires a validated definition. This paper describes the development and validation of a definition which includes criteria for specific medicines to determine whether a medication-monitoring error has occurred in the care home setting. Setting: Criteria were developed for older people (aged 65 years or older) living in care homes. Methods: Criteria were developed by two clinical pharmacists using published guidelines. The criteria were divided into those relating to initiation of therapy and maintenance monitoring. The study steering group, made up of clinical pharmacists, a general practitioner (GP) and pharmacy academics, then reviewed the criteria and a consensus was achieved. The criteria were then reviewed by a sample of 21 GPs and 11 clinical pharmacists. The threshold for acceptance for each criterion was set at 70% by agreement of all participants. Key findings: The definition of a medication-monitoring error was accepted as 'when a prescribed medicine is not monitored in the way which would be considered acceptable in routine general practice. It includes the absence of tests being carried out at the frequency listed in the criteria for each medicine, with tolerance of +50%'. Seventy per cent agreement was reached on all criteria for the initiation of therapy, except warfarin (69%), and on all criteria for maintenance monitoring, except penicillamine (63%) and potassium (63%). Conclusions: To our knowledge, this is the first study to define a medication-monitoring error, and to determine and validate specific criteria to identify such errors in older people living in care homes.
Gallivan S, Pagel C, Utley M, et al., 2008, A technical note concerning non-adherence to drug therapy: exact expressions for the mean and variance of drug concentration, HEALTH CARE MANAGEMENT SCIENCE, Vol: 11, Pages: 296-301, ISSN: 1386-9620
- Author Web Link
- Cite
- Citations: 4
Franklin BD, O'Grady K, 2008, Evaluating a dispensing robot in a UK hospital, PHARMACY WORLD & SCIENCE, Vol: 30, Pages: 393-394, ISSN: 0928-1231
Gilchrist M, Franklin BD, Patel JP, 2008, An outpatient parenteral antibiotic therapy (OPAT) map to identify risks associated with an OPAT service, JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol: 62, Pages: 177-183, ISSN: 0305-7453
- Author Web Link
- Cite
- Citations: 35
Franklin BD, 2008, Quantitative data, Pharmaceutical Journal, Vol: 280, ISSN: 0031-6873
Agha S, Bullock P, Franklin BD, 2008, Does the introduction of 'one-stop dispensing' affect the incidence of missed doses?, PHARMACY WORLD & SCIENCE, Vol: 30, Pages: 299-300, ISSN: 0928-1231
Birch SL, Karia R, Franklin BD, 2008, What is the impact of one stop dispensing on ward pharmacists' time?, PHARMACY WORLD & SCIENCE, Vol: 30, Pages: 301-302, ISSN: 0928-1231
Brown C, Hofer T, Johal A, et al., 2008, An epistemology of patient safety research: a framework for study design and interpretation. Part 3. End points and measurement, QUALITY & SAFETY IN HEALTH CARE, Vol: 17, Pages: 170-177, ISSN: 1475-3898
- Author Web Link
- Cite
- Citations: 82
Brown C, Hofer T, Johal A, et al., 2008, An epistemology of patient safety research: a framework for study design and interpretation. Part 2. Study design, QUALITY & SAFETY IN HEALTH CARE, Vol: 17, Pages: 163-169, ISSN: 1475-3898
- Author Web Link
- Cite
- Citations: 85
Brown C, Hofer T, Johal A, et al., 2008, An epistemology of patient safety research: a framework for study design and interpretation. Part 4. One size does not fit all, QUALITY & SAFETY IN HEALTH CARE, Vol: 17, Pages: 178-181, ISSN: 1475-3898
- Author Web Link
- Cite
- Citations: 49
Brown C, Hofer T, Johal A, et al., 2008, An epistemology of patient safety research: a framework for study design and interpretation. Part 1. Conceptualising and developing interventions, QUALITY & SAFETY IN HEALTH CARE, Vol: 17, Pages: 158-162, ISSN: 1475-3898
- Author Web Link
- Cite
- Citations: 58
Maidment ID, Haw C, Stubbs J, et al., 2008, Medication errors in older people with mental health problems: a review, INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 23, Pages: 564-573, ISSN: 0885-6230
- Author Web Link
- Cite
- Citations: 24
Franklin BD, O'Grady K, Voncina L, et al., 2008, An evaluation of two automated dispensing machines in UK hospital pharmacy, International Journal of Pharmacy Practice, Vol: 16, Pages: 47-53, ISSN: 0961-7671
Objective: To assess the impact of two different automated dispensing machines ('robots') on safety, efficiency and staff satisfaction, in a UK hospital setting. Setting: An NHS teaching hospital trust with two main sites each comprising 450 beds. A Swisslog Pack Picker automated dispensing machine was installed in the dispensary at site 1 in December 2003, and a Rowa Speedcase at site 2 in October 2005. Method: A before-and-after study design was used on each site, with site 2 acting as a control for site 1. Staff recorded data on dispensing errors identified at the final-check stage; an observer recorded the time taken to label, pick and assemble dispensed items; we recorded turnaround times for the different types of prescription and assessed storage space efficiency. We also used questionnaires to explore staff views. Key findings: The robot resulted in a significant decrease in dispensing errors on each site (from 2.7 to 1.0% of dispensed items on site 1, and from 1.2 to 0.6% on site 2). Reductions occurred in errors involving wrong content; there was no clear effect on labelling errors. There were reductions in the time required to pick items for dispensing; there was no impact on labelling or assembly times. There was no conclusive effect on turnaround times. Increases in storage capacity occurred on each site; staff on site 2 were more satisfied following introduction of the robot; there was no difference on site 1. Conclusion: Installation of a dispensary robot has modest benefits in terms of reduced dispensing errors, reduced picking times, increased staff satisfaction and increased storage capacity; there was no conclusive impact on turnaround times. These findings seem to be independent of the type of robot installed. © 2008 The Authors.
Donyai P, O'Grady K, Jacklin A, et al., 2008, The effects of electronic prescribing on the quality of prescribing, BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Vol: 65, Pages: 230-237, ISSN: 0306-5251
- Author Web Link
- Cite
- Citations: 102
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.