Background

Medication errors (MEs) in hospital settings are attributed to various factors including the human factors. Human factors researches are aiming to implement the knowledge regarding human nature and their interaction with surrounding equipment and environment to design efficient and safe systems. Human Factors Frameworks (HFF) developed awareness regarding main system's components that influence healthcare system and patients' safety. An in-depth evaluation of human factors contributing to medication errors in the hospital pharmacy is crucial to prevent such errors.

Objective

This study, therefore, aims to identify and categorize the human factors of MEs in hospital pharmacy using the Human Factors Framework (HFF).

Method

A qualitative study conducted in King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Data collection was carried out in two stages; the first stage was the semi-structured interview with the pharmacist or technician involved in the medication error. Then, occupational burnout and personal fatigue scores of participants were assessed. Data analysis was done using thematic analysis.

Results

A total of 19 interviews were done with pharmacists and technicians. Themes were categorized using HFF into five categories; individual, organization and management, task, work, and team factors. Examples of these themes are poor staff competency, insufficient staff support, Lack of standardization, workload, and prescriber behaviour respectively. Scores of fatigue, work disengagement, and emotional exhaustion are correlating with medium fatigue, high work disengagement, and high emotional exhaustion, respectively.

Conclusions

The study provided a unique insight into the contributing factors to MEs in the hospital pharmacy. Emotional stress, lack of motivation, high workload, poor communication, and missed patient information on the information system, are examples of the human factors contributing to medication errors. Our study found that among those factors, organizational factors had a major contribution to medication safety and staff wellbeing.

中文翻译：

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分类和理解与人为因素相关的医院药房用药错误

背景

医院环境中的用药错误 (ME) 归因于各种因素，包括人为因素。人因研究旨在运用关于人性及其与周围设备和环境相互作用的知识，设计出高效和安全的系统。人为因素框架 (HFF) 提高了对影响医疗保健系统和患者安全的主要系统组件的认识。深入评估导致医院药房用药错误的人为因素对于防止此类错误至关重要。

客观的

因此，本研究旨在使用人为因素框架 (HFF) 对医院药房中 ME 的人为因素进行识别和分类。

方法

在沙特阿拉伯王国利雅得的沙特国王医疗城进行的定性研究。数据收集分两个阶段进行；第一阶段是与涉及用药错误的药剂师或技术人员进行半结构化访谈。然后，评估参与者的职业倦怠和个人疲劳评分。数据分析采用专题分析。

结果

总共对药剂师和技术人员进行了 19 次访谈。使用 HFF 将主题分为五类；个人、组织和管理、任务、工作和团队因素。这些主题的例子分别是员工能力差、员工支持不足、缺乏标准化、工作量和处方者行为。疲劳、工作脱离和情绪疲惫的得分分别与中度疲劳、高度工作脱离和高度情绪疲惫相关。

结论

该研究对医院药房中 ME 的影响因素提供了独特的见解。情绪压力、缺乏动力、工作量大、沟通不畅以及在信息系统上遗漏患者信息，都是导致用药错误的人为因素的例子。我们的研究发现，在这些因素中，组织因素对用药安全和员工福祉有重大贡献。