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Safety and efficiency of a new generic package labelling: a before and after study in a simulated setting
  1. Beate Hennie Garcia1,2,
  2. Renate Elenjord2,
  3. Camilla Bjornstad2,
  4. Kjell Hermann Halvorsen1,
  5. Sigurd Hortemo3,
  6. Steinar Madsen3
  1. 1 Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
  2. 2 Hospital Pharmacy of North Norway Trust, Tromso, Norway
  3. 3 The Norwegian Medicines Agency, Oslo, Norway
  1. Correspondence to Dr Beate Hennie Garcia, Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromso, Norway; beate.garcia{at}


Background Medication errors are frequent and may cause harm to patients and increase healthcare expenses.

Aim To explore whether a new labelling influences time and errors when preparing medications in accordance with medication charts in an experimental setting.

Method We carried out an uncontrolled before and after study with 3 months inbetween experiments. Phase I used original labelling and phase II used new generic labelling. We set up an experimental medicine room, simulating a real-life setting. Twenty-five nurses and ten pharmacy technicians participated in the study. We asked them to prepare medications in accordance with medication charts, place packages on a desk and document the package prepared. We timed the operation. Participants were asked to prepare medications in accordance with as many charts as possible within 30 min.

Results Nurses prepared significantly more medication charts with the generic labelling compared with the original 3.3 versus 2.6 (p=0.009). Mean time per medication chart was significantly lower with the generic labelling 6.9 min/chart versus 8.5 min/chart (p<0.001). Pharmacy technicians were significantly faster than the nurses in both phase I (6.8 min/chart vs 9.5 min/chart; p<0.001) and phase II (6.1 min/chart vs 7.2 min/chart; p=0.013). The number of errors was low and not significantly different between the two labellings, with errors affecting 9.1% of charts in phase I versus 6.5% in phase II (p=0.5).

Conclusions A new labelling of medication packages with prominent placement of the active substance(s) and strength(s) in the front of the medication package may reduce time for nurses when preparing medications, without increasing medication errors.

  • Hospital medicine
  • Medical error, measurement/epidemiology
  • Medication safety
  • Nurses
  • Patient safety

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors All authors were involved in designing the study and interpreting results. BHG and KHH have performed the statistical analysis. BHG has drafted the manuscript, and all other authors have commented, revised and agreed upon the final manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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