How to avoid problems with look-alike and sound-alike drugs
Accreditation Connection, December 2, 2004
Separate drugs that are easy to confuse. This aims in reducing the chance that staff may hastily grab the wrong medication (addressed by EP #6). Jennifer Fulmer Groves, RPh, MPH, medication safety manager, at the Cleveland Clinic, identifies and separates all medications with the potential for confusion.
If an employee makes an error, she determines whether the drug's physical location is the cause. If so, she removes the less commonly used of the two drugs and places it in the "medication separation area," a shelf guarded by a red paper stop sign that states: "Caution: Look-alike/sound-alike drug."
Groves keeps drugs on these shelves to a minimum, with about two or three drugs per area located on each shelf. She sets a placeholder on the drug's former location and clips the stop sign to both of the drugs' bins.Groves also assesses the potential for confusion of look-alike and sound-alike drugs in Pyxis machines. For example, she has separated the locations of dopamine and dobutamine, which sound alike in name and have similar packaging.
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