Publications
270 results found
Barber N, Rawlins M, Franklin BD, 2003, Reducing prescribing error: competence, control, and culture, QUALITY & SAFETY IN HEALTH CARE, Vol: 12, Pages: I29-I32, ISSN: 1475-3898
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- Citations: 75
Franklin BD, Karia R, Bullock P, et al., 2003, One-stop dispensing - Does one size fit all?, Pharmaceutical Journal, Vol: 271, ISSN: 0031-6873
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- Citations: 5
Dean B, 2003, Adverse drug events: what's the truth?, QUALITY & SAFETY IN HEALTH CARE, Vol: 12, Pages: 165-166, ISSN: 1475-3898
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- Citations: 14
Dean B, 2003, Adverse drug events: what's the truth?, Qual Saf Health Care, Vol: 12, Pages: 165-166, ISSN: 1475-3898
Fowler G, Kirwan J, Ogunbiyi I, et al., 2003, Patients and medicine containers (multiple letters), Hospital Pharmacist, Vol: 10, ISSN: 1352-7967
Knox K, Lawson W, Dean B, et al., 2003, Multidisciplinary antimicrobial management and the role of the infectious diseases pharmacist - a UK perspective, JOURNAL OF HOSPITAL INFECTION, Vol: 53, Pages: 85-90, ISSN: 0195-6701
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- Citations: 40
Taxis K, Dean B, Barber N, 2002, The validation of an existing method of scoring the severity of medication administration errors for use in Germany, PHARMACY WORLD & SCIENCE, Vol: 24, Pages: 236-239, ISSN: 0928-1231
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- Citations: 13
Dean B, Schachter M, Vincent C, et al., 2002, Prescribing errors in hospital inpatients: their incidence and clinical significance, QUALITY & SAFETY IN HEALTH CARE, Vol: 11, Pages: 340-344, ISSN: 1475-3898
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- Citations: 255
Spinewine A, Dean B, 2002, Measuring the impact of medicines information services on patient care: methodological considerations, PHARMACY WORLD & SCIENCE, Vol: 24, Pages: 177-181, ISSN: 0928-1231
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- Citations: 16
Dean B, 2002, Learning from prescribing errors, QUALITY & SAFETY IN HEALTH CARE, Vol: 11, Pages: 258-260, ISSN: 1475-3898
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- Citations: 44
Cooke FJ, Dean B, 2002, Quality indicators for antibiotic control programmes, JOURNAL OF HOSPITAL INFECTION, Vol: 51, Pages: 237-238, ISSN: 0195-6701
Dean B, Schachter M, Vincent C, et al., 2002, Causes of prescribing errors in hospital inpatients: a prospective study, LANCET, Vol: 359, Pages: 1373-1378, ISSN: 0140-6736
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- Citations: 397
Franklin BD, Lawson W, Jacklin A, et al., 2002, The use of serial point prevalence studies to investigate anti-infective prescribing, International Journal of Pharmacy Practice, ISSN: 2042-7174
Sagripanti M, Dean B, Barber N, 2002, An evaluation of the process-related medication risks for elective surgery patients from pre-operative assessment to discharge, International Journal of Pharmacy Practice, Vol: 10, Pages: 161-170, ISSN: 0961-7671
Aim - To investigate where the process-related medication risks occur in an elective surgery service with a pre-operative assessment clinic (PAC) and make recommendations for how pharmacy services should best be provided. Method - The study involved identification of discrepancies in medication history taking, changes that occurred in patients' medication between PAC and admission, and changes that occurred between admission and discharge. Prescribing errors were identified and classified according to whether they occurred on admission, during the inpatient stay or on discharge, and whether they were identified and rectified by the existing pharmacy service. Setting - Seventy-six patients recruited from the nurse-led PAC of a 580-bed London teaching hospital between May 2 and June 30, 2000. Key findings - The PAC nurse omitted 27 per cent of medications from the medication history; the admitting doctor omitted 37 per cent from the medication history documented in the medical notes and 47 per cent from the inpatient medication chart; the majority of the omissions were complementary and over-the-counter preparations. Twenty-six per cent of patients had changes made to their medication between PAC and admission, and 85 per cent had changes made between admission and discharge. A total of 177 prescribing errors were identified (median of 1 error per patient; interquartile range 0-3), of which 38 per cent occurred on admission, 14 per cent during the inpatient stay and 48 per cent at discharge. Pharmacists made interventions to rectify 59 per cent of the errors. Conclusion - Given the large number of changes to patients' medication that occurred between PAC and admission, we would not support the writing of inpatient medication charts or the supply of medication at this stage. For this group of patients in the study hospital, the greatest process-related medication risks occurred on admission and discharge, and pharmacy services should be provided accordingly.
Potts D, 2002, Introduction, Guide lines for the use of advanced numerical analysis
Francis SA, Dean B, Rees C, 2001, There's more to interprofessional communication than sticky notes!, Pharmaceutical Journal, Vol: 267, ISSN: 0031-6873
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- Citations: 2
Dean B, Jacklin A, Mounsey A, et al., 2001, CPD implementation in a large NHS trust, Hospital Pharmacist, Vol: 8, Pages: 105-108, ISSN: 1352-7967
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- Citations: 5
MacGregor G, Sever P, 2001, Introduction, JOURNAL OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM, Vol: 2, Pages: 3-3, ISSN: 1470-3203
Dean B, Barber N, 2001, Validity and reliability of observational methods for studying medication administration errors, AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, Vol: 58, Pages: 54-59, ISSN: 1079-2082
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- Citations: 131
Dean B, Barber N, van Ackere A, et al., 2001, Can simulation be used to reduce errors in health care delivery? The hospital drug distribution system., J Health Serv Res Policy, Vol: 6, Pages: 32-37, ISSN: 1355-8196
OBJECTIVES: To construct a simulation model of the hospital drug distribution system, to evaluate the effects of different changes to the system on unavailability-related medication administration errors (U-MAEs), to test the most promising system in a controlled trial and to explore the model's validity. METHODS: A discrete-event simulation model of the drug distribution system was constructed, using data collected on a vascular surgery ward and a renal medicine ward as model inputs. The model's output was the U-MAE rate. The model was used to explore the effects on U-MAEs of different changes to the system. One of the changes predicted to reduce U-MAEs, a patients' own drugs scheme, was introduced on each study ward; U-MAE rates were measured using observations before and after its introduction and compared with those predicted by the model. RESULTS: The model predicted that the introduction of a patients' own drugs system would reduce unavailability-related errors on each ward; in practice, there was a slight decrease on the medical ward but an increase on the surgical ward. Reasons for these findings were explored and four contributing factors identified. Three of these related to failure to follow hospital procedures, the fourth to an issue for which no policy existed. If these factors had been taken into account, the error rates predicted by the model would have been similar to those observed. CONCLUSIONS: Simulation modelling is a potentially useful approach to the study of U-MAEs, although care must be taken to ensure that such models reflect actual practice rather than stated policy.
Dean B, Barber N, Schachter M, 2000, What is a prescribing error?, QUALITY IN HEALTH CARE, Vol: 9, Pages: 232-237, ISSN: 0963-8172
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- Citations: 272
Dean B, Barber N, 2000, The effects of a patients' own drugs scheme on the incidence and severity of medication administration errors, International Journal of Pharmacy Practice, Vol: 8, Pages: 209-216, ISSN: 0961-7671
Background - Many UK hospitals are introducing patients' own drugs (PODs) schemes, in which patients' own medication is used during their stay. It has been suggested that these will reduce medication administration errors (MAEs), particularly those due to medication unavailability. Objective - To explore the effects of introducing a PODs system on the incidence and severity of MAEs. Method and setting - An observational method was used to identify MAEs before and after introducing a PODs system on one surgical and one medical ward in a teaching hospital in the United Kingdom. MAEs were classified as being due to unavailability (U-MAEs) or other reasons (O-MAEs). A validated severity assessment method was applied to the MAEs identified. Key results - The overall MAE rate for the traditional ward pharmacy system was 4.3 per cent and for the PODs system it was 4.2 per cent (P=0.99, chi square test). There were also no significant differences in U-MAE or O-MAE rates, types of MAE or their severity. There were several potential reasons why the PODs system did not reduce U-MAEs. These included the informal use of patients' own medication in the traditional ward pharmacy system and one patient prescribed a non-formulary drug who accounted for many of the U-MAEs observed. Logistic regression analyses indicated that U-MAE rates were affected by time of day and day of week, and O-MAE rates by day of week and administering nurse. Conclusion - It was concluded that the introduction of a PODs system had little effect on MAEs.
Dean B, 1999, Errors in medication administration, INTENSIVE CARE MEDICINE, Vol: 25, Pages: 341-342, ISSN: 0342-4642
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- Citations: 9
Taxis K, Dean B, Barber N, 1999, Hospital drug distribution systems in the UK and Germany - a study of medication errors, PHARMACY WORLD & SCIENCE, Vol: 21, Pages: 25-31, ISSN: 0928-1231
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- Citations: 80
Dean BS, Barber ND, 1999, A validated, reliable method of scoring the severity of medication errors, British Pharmaceutical Conference, Publisher: AMER SOC HEALTH-SYSTEM PHARMACISTS, Pages: 57-62, ISSN: 1079-2082
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- Citations: 120
Dean B, van Ackere A, Gallivan S, et al., 1999, When should pharmacists visit their wards? An application of simulation to planning hospital pharmacy services., Health Care Manag Sci, Vol: 2, Pages: 35-42, ISSN: 1386-9620
This paper reports a pilot study of the use of simulation in planning hospital pharmacy services. The objectives were to create a simulation model of the hospital drug distribution system, to use the model to investigate a simple problem and to assess the potential for simulation to aid decision making in hospital pharmacy management. The problem chosen for investigation focused on the UK ward pharmacy system, where a pharmacist visits each ward daily to initiate the supply of newly prescribed non-stock medication. A simulation model was used to investigate how changing the time of the ward pharmacist's visit could affect the mean time delay between the prescription of a non-stock drug and the arrival of that drug on the ward. The simulation results suggest that the time of day at which pharmacists visit their wards can have a major impact on delay times, and that the relative benefit of different visit times is likely to vary between wards. Simulation was found to be a useful approach to investigating different service alternatives without the expense and disruption of assessing each in practice.
Dean BS, Gallivan S, Barber ND, et al., 1997, Mathematical modeling of pharmacy systems, AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, Vol: 54, Pages: 2491-2499, ISSN: 1079-2082
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- Citations: 6
Ho CYW, Dean BS, Barber ND, 1997, When do medication administration errors happen to hospital inpatients?, International Journal of Pharmacy Practice, Vol: 5, Pages: 91-96, ISSN: 0961-7671
The aim of this study was to determine when medication administration errors (MAEs) are most likely to occur. MAEs were identified by observing nurses preparing and administering medication on a care of the elderly ward during two eight-day periods. The exposure of individual patients to MAEs was also determined. A total of 119 MAEs was identified during the observation of 2,170 opportunities for error, representing an error rate of 5.5 per cent (95 per cent confidence interval, 4.5 per cent to 6.4 per cent). The omission of drugs that were not available on the ward was the predominant type of error. Of the 56 study patients, 35 experienced at least one MAE during the study period. Errors occurred at an average rate of at least 0.3 errors per patient day. The MAE rate was significantly higher on weekdays (6.4 per cent) than during weekends (4.0 per cent) and higher during pharmacy opening hours (7.8 per cent) than when the pharmacy was closed (4.6 per cent). Patients were at greatest risk of MAEs in the first 48 hours of admission and in the first 48 hours after prescribing. A multidisciplinary approach is required to design safer systems.
Dean B, Poolman R, 1996, Are incompatibilities a problem?, Pharmacy in Practice, Vol: 6, Pages: 371-372, ISSN: 0962-9734
Critically ill patients frequently receive more than one drug infusion via the same intravenous line. Some combinations of drugs are documented to be compatible, others are not. Our objectives were to identify the combinations of drugs commonly infused via the same line in an intensive care unit (ICU) and to determine whether these were compatible. An observer visited the ICU daily for two months and recorded all combinations of infusions given using the same line. Standard reference sources were used to determine the compatibility of each combination. There were 42 different combinations of drugs infused via the same line. Twenty one combinations (50 per cent) were documented to be compatible, one was incompatible. For the remaining 20 (48 per cent) there was no published information available. Further research into compatibilities is urgently required.
DEAN BS, ALLAN EL, BARBER ND, et al., 1995, COMPARISON OF MEDICATION ERRORS IN AN AMERICAN AND A BRITISH HOSPITAL, AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, Vol: 52, Pages: 2543-2549, ISSN: 1079-2082
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- Citations: 85
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