Pharmacy Student Knowledge and Communication of Medication Errors

By Rickles, Nathaniel M.; Noland, Carey M. et al. | American Journal of Pharmaceutical Education, May 2010 | Go to article overview

Pharmacy Student Knowledge and Communication of Medication Errors


Rickles, Nathaniel M., Noland, Carey M., Tramontozzi, Anthony, Vinci, Michele A., American Journal of Pharmaceutical Education


INTRODUCTION

The Accreditation Council for Pharmacy Education and the American Association of Colleges of Pharmacy both recognize the importance of patient safety as a core component of pharmacy education. (1,2) The proceedings of a national stakeholder summit listed a recommendation that medication safety should be included in all professional school curriculums. (3) The Food and Drug Administration's (FDA) Strategic Plan also supports pharmacists' understanding of the science of safety to ensure their active participation in the development, implementation, and/or evaluation of new initiatives to improve the consumer's safe use of medical products. (4)

Limited research has been conducted on what pharmacists and pharmacy students have learned about medication safety, (5-9) indicating considerable variation on the nature and depth of medication safety topics taught. Pharmacy programs providing medication safety instruction typically offer topics such as the nomenclature, frequency, cost, and morbidity/mortality associated with medication errors. One innovative program augmented the classroom approach by teaching medication safety and error reduction topics through student projects at institutional and community pharmacy sites. (9) In this program, student knowledge and motivation to report and prevent errors was improved. It is not clear, however, what schools and colleges of pharmacy teach students about how they should communicate with patients and pharmacy staff members when medication errors occur, and how to prevent and/or intercept errors. Procedural knowledge of actions to take for the management and prevention of errors is vital for pharmacy students to effectively interact with patients and colleagues. During internships, pharmacists and pharmacy students often communicate about issues that arise, such as misunderstanding a prescriber's written or verbal prescription, giving a correctly filled prescription to the wrong patient, and assuming a prescription was checked when it had not been. Depending on the nature of the problem, medication errors often are received by patients as well as pharmacy personnel with considerable worry, fear, and disappointment. Poor communication between providers and patients can contribute to medication errors and other negative outcomes. (10-13) Likewise, good provider-patient communication skills facilitate the development of trust between providers and patients, reduce patient anxiety, improve patient satisfaction, and minimize the frequency of lawsuits. (14-17)

A clinician's lack of comfort with disclosure of medication errors is sometimes a barrier to good communication skills. Clinicians often are reluctant to report and disclose errors. Patients report that they typically are not given a clear explanation on what to do if an unanticipated medication outcome occurs, and they often feel distanced from health care staff members and organizations because they get few answers when a medication error does occur. (18) Patients want errors to be disclosed and usually seek information about why the error happened, how the error's consequences are to be mitigated, and how recurrences are to be prevented. (19) Harmful and serious medical errors are infrequently disclosed to patients. (20) Multiple factors prevent providers from full disclosure of errors including apprehension that informing the patient of the error could lead to a lawsuit, damage to the clinician's reputation, job loss, and awkward clinical interactions. (19,20)

When medication errors occur, negative outcomes result from poor communication. Pharmacy educators should explore how comfortable students are in communicating with colleagues and patients to manage and prevent medication errors. One study investigated the training of pharmacy students in communicating the management and prevention of medication errors. (21) This qualitative study was comprised of 44 in-depth, semi-structured interviews of pharmacy students who were predominantly in their third, fourth, or fifth professional year of a 6-year pharmacy program. …

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Pharmacy Student Knowledge and Communication of Medication Errors
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