Matching Items (2)
132311-Thumbnail Image.png
Description
Currently, medical errors are one of the most common causes of death in the United
States (Makary & Daniel, 2016), which includes errors related to look-alike, sound-alike prescription drug name confusion. The use of Tall Man lettering, a text enhancement style that capitalizes the dissimilar portions of words, has been recommended

Currently, medical errors are one of the most common causes of death in the United
States (Makary & Daniel, 2016), which includes errors related to look-alike, sound-alike prescription drug name confusion. The use of Tall Man lettering, a text enhancement style that capitalizes the dissimilar portions of words, has been recommended by the US Food and Drug Administration (FDA) as well as the Institute for Safe Medication Practices (ISMP) since 2008 in order to make it easier for healthcare professionals to distinguish and identify two otherwise easily confusable drug names. Research performed on the efficacy of Tall Man lettering and similar text enhancements in successfully differentiating look-alike, sound-alike drug names has thus far been either null or inconclusive. Therefore, it is crucial that further research be conducted in order to provide a path to alleviation by increasing the understanding of the problem, and providing evidence to a clearer solution (Lambert, Schroeder & Galanter, 2015). The objective of the current study was to measure the efficacy of Tall Man Lettering and additional text enhancement strategies through an experiment that replicates some of the previously used methods of research. The current study utilized a repeated measures design. Participants were shown a prime drug name, followed by a brief mask, and then either the same drug name or its confusable drug name pair. They were then asked to identify whether the two drug names presented were identical or different. All of the participants completed a total of four trials representing each condition (regular, Tall Man, Tall Man Bold, highlight) and a practice trial. Overall performance was measured through accuracy and reaction time, which revealed that regular, lowercase text was more effective than any of the other text enhancements, including Tall Man lettering, in quickly and accurately identifying differences in drug names. These results seem to add to the body of inconclusive research on the efficacy of Tall Man lettering and similar text enhancement strategies for reducing drug name confusion. Given the significant impact that drug name confusion errors can have on patient safety, it is imperative that further research be conducted in order to give a more definitive answer of whether text enhancement strategies like Tall Man lettering are helpful in practice.
ContributorsThompson, Alyssa Brianna (Author) / Branaghan, Russell (Thesis director) / Gutzwiller, Robert (Committee member) / Engineering Programs (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
156054-Thumbnail Image.png
Description
Medical errors are now estimated to be the third leading cause of death in the United States (Makary & Daniel, 2016). Look-alike, sound- alike prescription drug mix-ups contribute to this figure. The US Food and Drug Administration (FDA) and Institute for Safe Medication Practices (ISMP) have recommended the use of

Medical errors are now estimated to be the third leading cause of death in the United States (Makary & Daniel, 2016). Look-alike, sound- alike prescription drug mix-ups contribute to this figure. The US Food and Drug Administration (FDA) and Institute for Safe Medication Practices (ISMP) have recommended the use of Tall Man lettering since 2008, in which dissimilar portions of confusable drug names pairs are capitalized in order to make them more distinguishable. Research on the efficacy of Tall Man lettering in differentiating confusable drug name pairs has been inconclusive and it is imperative to investigate potential efficacy further considering the clinical implications (Lambert, Schroeder & Galanter, 2015). The present study aimed to add to the body of research on Tall Man lettering while also investigating another possibility for the mechanism behind Tall Man’s efficacy, if it in fact exists. Studies indicate that the first letter in a word offers an advantage over other positions, resulting in more accurate and faster recognition (Adelman, Marquis & Sabatos-DeVito, 2010; Scaltritti & Balota, 2013). The present study used a 2x3 repeated measures design to analyze the effect of position on Tall Man lettering efficacy. Participants were shown a prime drug, followed by a brief mask, and then either the same drug name or its confusable pair and asked to identify whether they were the same or different. All participants completed both lowercase and Tall Man conditions. Overall performance measured by accuracy and reaction time revealed lowercase to be more effective than Tall Man. With regard to the position of Tall Man letters, a first position advantage was seen both in accuracy and reaction time. A first position advantage was seen in the lowercase condition as well, suggesting the location of the differing portion of the word matters more than the format used. These findings add to the body of inconclusive research on the efficacy of Tall Man lettering in drug name confusion. Considering its impact on patient safety, more research should be conducted to definitively answer the question as to whether or not Tall Man should be used in practice.
ContributorsKnobloch, Ashley (Author) / Branaghan, Russell (Thesis advisor) / Cooke, Nancy J. (Committee member) / Gray, Robert (Committee member) / Arizona State University (Publisher)
Created2017