Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names

Rationale, aims and objectives - Confusion between similar drug names can cause harmful medication errors. Similar drug names can be visually differentiated using a typographical technique known as Tall Man lettering. While international conventions exist to derive Tall Man representation for drug n...

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Main Authors: Emmerton, Lynne, Rizk, M., Bedford, G., Lalor, D.
Format: Journal Article
Published: Wiley-Blackwell Publishing 2015
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/32153
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author Emmerton, Lynne
Rizk, M.
Bedford, G.
Lalor, D.
author_facet Emmerton, Lynne
Rizk, M.
Bedford, G.
Lalor, D.
author_sort Emmerton, Lynne
building Curtin Institutional Repository
collection Online Access
description Rationale, aims and objectives - Confusion between similar drug names can cause harmful medication errors. Similar drug names can be visually differentiated using a typographical technique known as Tall Man lettering. While international conventions exist to derive Tall Man representation for drug names, there has been no national standard developed in Australia. This paper describes the derivation of a risk-based, standardized approach for use of Tall Man lettering in Australia, and known as National Tall Man Lettering. Method - A three-stage approach was applied. An Australian list of similar drug names was systematically compiled from the literature and clinical error reports. Secondly, drug name pairs were prioritized using a risk matrix based on the likelihood of name confusion (a four-component score) vs. consensus ratings of the potential severity of the confusion by 31 expert reviewers. The mid-type Tall Man convention was then applied to derive the typography for the highest priority drug pair names. Results - Of 250 pairs of confusable Australian drug names, comprising 341 discrete names, 35 pairs were identified by the matrix as an ‘extreme’ risk if confused. The mid-type Tall Man convention was successfully applied to the majority of the prioritized drugs; some adaption of the convention was required. Conclusion - This systematic process for identification of confusable drug names and associated risk, followed by application of a convention for Tall Man lettering, has produced a standard now endorsed for use in clinical settings in Australia. Periodic updating is recommended to accommodate new drug names and error reports.
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institution Curtin University Malaysia
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spelling curtin-20.500.11937-321532019-02-19T05:35:35Z Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names Emmerton, Lynne Rizk, M. Bedford, G. Lalor, D. errors standard look-alike Tall Man sound-alike drug confusion Rationale, aims and objectives - Confusion between similar drug names can cause harmful medication errors. Similar drug names can be visually differentiated using a typographical technique known as Tall Man lettering. While international conventions exist to derive Tall Man representation for drug names, there has been no national standard developed in Australia. This paper describes the derivation of a risk-based, standardized approach for use of Tall Man lettering in Australia, and known as National Tall Man Lettering. Method - A three-stage approach was applied. An Australian list of similar drug names was systematically compiled from the literature and clinical error reports. Secondly, drug name pairs were prioritized using a risk matrix based on the likelihood of name confusion (a four-component score) vs. consensus ratings of the potential severity of the confusion by 31 expert reviewers. The mid-type Tall Man convention was then applied to derive the typography for the highest priority drug pair names. Results - Of 250 pairs of confusable Australian drug names, comprising 341 discrete names, 35 pairs were identified by the matrix as an ‘extreme’ risk if confused. The mid-type Tall Man convention was successfully applied to the majority of the prioritized drugs; some adaption of the convention was required. Conclusion - This systematic process for identification of confusable drug names and associated risk, followed by application of a convention for Tall Man lettering, has produced a standard now endorsed for use in clinical settings in Australia. Periodic updating is recommended to accommodate new drug names and error reports. 2015 Journal Article http://hdl.handle.net/20.500.11937/32153 10.1111/jep.12247 Wiley-Blackwell Publishing fulltext
spellingShingle errors
standard
look-alike
Tall Man
sound-alike
drug
confusion
Emmerton, Lynne
Rizk, M.
Bedford, G.
Lalor, D.
Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
title Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
title_full Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
title_fullStr Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
title_full_unstemmed Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
title_short Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
title_sort systematic derivation of an australian standard for tall man lettering to distinguish similar drug names
topic errors
standard
look-alike
Tall Man
sound-alike
drug
confusion
url http://hdl.handle.net/20.500.11937/32153