Effectivity of Smart Box to Decrease Pre-Dispensing Error of Cefazolin and Ceftriaxone

Abstract

Pre-dispensing errors are frequently observed among look-alike, sound-alike (LASA) medications, particularly the injectable pair: cefazolin and ceftriaxone. To address this concern, a medication storage cabinet incorporating barcode technology was developed. This device, referred to as the “smart box” integrates a barcode scanner with an automatic locking mechanism; when the barcode on the medication label is scanned, only the corresponding compartment is released. This action research aimed to assess the effectiveness of the smart box in reducing pre-dispensing errors involving cefazolin and ceftriaxone injections. Inpatient prescriptions for either drug were collected during two periods: routine dispensing (24–28 April 2023) and dispensing assisted by the smart box (1–5 May 2023). The sample size, based on prior studies, comprised 65 prescriptions per period. Pre-dispensing errors (wrong drug and wrong quantity) were recorded. Descriptive statistics were employed for general data analysis, and Fisher’s exact probability test was used to compare error proportions between the two dispensing methods. Most prescriptions were categorized as continued orders, and the proportions of cefazolin and ceftriaxone prescriptions did not differ significantly between the study periods. The smart box period demonstrated a significantly lower rate of pre-dispensing errors compared to the routine dispensing (4.62% vs. 27.69%, p=0.001). All errors detected in the smart box period were wrong-quantity dispensing; and no wrongdrug errors were observed. The development of this cost-effective device, the smart box, which addresses identified operational challenges, represents a feasible approach to enhance medication-use safety.