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ANDREW V. ROMERO, PHARM.D., is Pharmacist, University Medical Center, Tucson, AZ. DANIEL C. MALONE, PH.D., is Associate Professor, College of Pharmacy, University of Arizona, Tuscon.

Address correspondence to Dr. Malone at the College of Pharmacy, University of Arizona, 1703 East Mabel, Tucson, AZ 85721-0207 (malone{at}pharmacy.arizona.edu).

Purpose. The accuracy of adverse-drug-event (ADE) reports collected using an automated dispensing system was evaluated. Methods. ADE reports were collected by requiring nurses on five units in a tertiary care facility to select a reason for removing two tracer drugs (dextrose injection 50% [D50] and naloxone) from an automated dispensing system (Medstation 2000, Pyxis, San Diego, CA). The accuracy of the ADE reports during a period of 4.5 months was evaluated through retrospective chart review. The sensitivity, specificity, positive predictive value, and negative predictive value of the reports were calculated. Results. A review of 61 D50 transactions found that the appropriate reason for removal was selected by nursing staff 62% of the time. Twenty-seven transactions were recorded as occurring due to an ADE, and 70% of these were confirmed in the medical record. The sensitivity and specificity of the ADE reports for D50 were 55.9% (95% confidence interval [CI], 39.2–72.6%) and 70.4% (95% CI, 53.2–87.6%), respectively. A review of 32 naloxone transactions found that nurses correctly selected the reason for removal 88% of the time. Twenty-three transactions were recorded as occurring due to an ADE, and 87% of these were confirmed in the medical record. The sensitivity and specificity of the ADE reports for naloxone were 95.2% (95% CI, 86.1–104.4%) and 72.7% (95% CI, 46.4–99.1%), respectively. Conclusion. A Pyxis ADE reporting mechanism using the tracer drugs D50 and naloxone increased the overall reporting of ADEs. Index terms: Automation; Caloric agents; Dextrose; Dispensing; Dosage; Drug use; Drugs, adverse reactions; Errors, medication; Methodology; Naloxone; Opiate antagonists; Opiates; Poisoning; Reports

 

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