Laboratory Session to Improve First-Year Pharmacy Students' Knowledge and Confidence concerning the Prevention of Medication Errors

Article excerpt

INTRODUCTION

The Institute of Medicine's (IOM) Committee on Quality of Health Care in America ranked medical errors as the eighth leading cause of death in the United States. (1) In addition, the IOM reported an increase in adverse drug events due to medication errors, suggesting the need for greater recognition and prevention of medication errors by future pharmacists. (1) The IOM acknowledged that medical errors are often due to problems embedded in inadequately designed healthcare systems rather than as a result of negligent healthcare practitioners, which indicates a need to implement systems to decrease medical errors. (1,2)

Patient safety should be of prime concern in all areas of pharmacy practice. (3-7) Pharmacists should be encouraged to develop and improve safe and effective medication use techniques. (4-7) When providing pharmaceutical care, it is a pharmacist's responsibility to direct patients to valid sources of information and safe medication use, since medication information commonly available to patients is often inaccurate, difficult to interpret, or inconsistent with principles of cultural sensitivity. (5-11) The American Association of Colleges of Pharmacy (AACP) has provided leadership on safe medication use, resulting in their support of innovations that establish and expand interprofessional models for educating students on patient safety. (4) The AACP encouraged pharmacy faculty members to lead a national collaborative approach to medication safety research that extends beyond measuring accuracy and investigates the components of a broader definition of errors. (11)

Pharmacy students should be educated to support safe medication practices in various settings and professionalized to consider patient medication safety as their personal responsibility. The Accreditation Council on Pharmacy Education (ACPE) requires that pharmacy schools ensure that their curricula contain aspects of patient safety. (12) ACPE encourages critical thinking and development of problem-solving skills through the use of laboratory experiences, guided group discussions, and simulated practice experiences. Active-learning strategies should be employed to promote the maturation of skills needed in future pharmacy practice. Instructors are encouraged to experiment with teaching methods based on sound educational principles and best evidence in educational practice and to assess the effectiveness of these methods. (12)

Efforts have been made nationally to incorporate medication error instruction into pharmacy curricula. Based on the results of a national survey of colleges and schools of pharmacy in 2002, the majority of responding institutions embed medication error instruction in pharmacy administration, therapeutics, or law courses. Six domains of medication error instruction (human error, medical errors, medication errors, quality or process improvement, root cause analysis, and failure mode and effects analysis) were identified. (6) A number of schools indicated that instruction in these specific domains was lacking in their curriculum, including: human error (44%), medical errors (32%), root cause analysis (62%), and failure mode and effects analysis (79%). The majority of instruction was didactic with few institutions incorporating active learning within laboratories. Of those using laboratories, specific content was not described. The authors of the survey recommended standardizing medication error instruction. (6)

Medication error instruction is incorporated into each professional year of the curriculum at Purdue University School of Pharmacy and Pharmaceutical Sciences. In the first year, didactic instruction is coupled with an introductory pharmacy practice experience (IPPE) called Observations in a Community Pharmacy. The 2 activities culminate in a year-end debriefing laboratory, which provides the student with opportunities to demonstrate knowledge, practice skills, and reflect on optimal methods to prevent errors. …