ABSTRACT
Research applying human factors and safety engineering to patient safety dates back to at least 1960 (ChapanisandSafren1960,SafrenandChapanis1960)toastudyonhospitalmedicationerrorsbyone ofthefoundersofhumanfactorsengineering(Chapanis).Ÿeauthorsconcluded,amongotherthings, thatavarietyofrisksexistedinthemedicationprocessincludinghard-to-readdecimalplacesindrug orders,useofabbreviations,poorhandwriting,difficultdruglabels,poorarrangementofdrugsinthe pharmacy,anddistractions.Recently,especiallyinhospitalsettings,manyofthoseriskfactors,and resultant medical errors, are receiving renewed attention (Institute of Medicine 2000, 2001, 2007).
