Tablet-splitting: a common yet not so innocent practice.

Charlotte Verrue; Els Mehuys; Koen Boussery; Jean-Paul Remon; Mirko Petrovic

Study

Tablet-splitting: a common yet not so innocent practice.

January 19, 2011

Verrue C, Mehuys E, Boussery K, et al. J Adv Nurs. 2011;67(1):26-32.

View more articles from the same authors.

Pharmacists and patients commonly split pills in order to increase dose flexibility and make pills easier to swallow. However, this study found that splitting pills resulted in unpredictable dose deviations, which could lead to underdosing or overdosing.

PubMed citation

Available at

Related Resources From the Same Author(s)

Strategies to reduce the risk of iatrogenic illness in complex older adults.

May 15, 2013

Seen through the patients' eyes: safety of chronic illness care.

December 13, 2017

Why we need a single definition of disruptive behavior.

June 27, 2018

Implementing a perioperative handoff tool to improve postprocedural patient transfers.

March 7, 2012

The relationship of self-report of quality to practice size and health information technology.

October 10, 2012

E-learning on risk management. An opportunity for sharing knowledge and experiences in patient safety.

January 30, 2019

Accuracy of emergency department clinical findings for diagnosis of coronavirus disease 2019.

July 29, 2020

Managing clinical failure: a complex adaptive system perspective.

May 30, 2007

Incidence of adverse events related to health care in Spain: results of the Spanish National Study of Adverse Events.

December 3, 2008

A novel process audit for standardized perioperative handoff protocols.

November 1, 2017

Do we know what foundation year doctors think about patient safety incident reporting? Development of a web based tool to assess attitude and knowledge.

August 17, 2011

Proceed with reasonable care: when legal principles inform training to prevent harm during the childbirth.

February 9, 2022

Trend analysis of radiation therapy incidents over seven years.

August 25, 2010

Pilot implementation of a perioperative protocol to guide operating room-to-intensive care unit patient handoffs.

February 29, 2012

Does your patient really understand?

November 9, 2011

A quality improvement initiative using peer audit and feedback to improve compliance with the surgical safety checklist.

July 27, 2022

The use of "lives saved" measures in nurse staffing and patient safety research: statistical considerations.

March 30, 2011

Systematic literature review on the effectiveness and safety of paediatric hospital-at-home care as a substitute for hospital care.

May 17, 2023

Medical errors reported by French general practitioners in training: results of a survey and individual interviews.

April 4, 2012

Are physicians safely prescribing opioids for chronic noncancer pain? A systematic review of current evidence.

December 14, 2016

Cleaning up the discharge process: a number of components—and personnel—are crucial to success.

October 20, 2010

Predicting and preventing adverse drug reactions in the very old.

June 8, 2005

Patterns of unexpected in-hospital deaths: a root cause analysis.

March 16, 2011

Patients as diagnostic collaborators: sharing visit notes to promote accuracy and safety.

May 22, 2019

Estimation of breast cancer overdiagnosis in a U.S. breast screening cohort.

March 16, 2022

Prevalence of adverse events in the hospitals of five Latin American countries: results of the 'Iberoamerican Study of Adverse Events' (IBEAS).

August 10, 2011

Interventions for preventing falls in acute- and chronic-care hospitals: a systematic review and meta-analysis.

December 12, 2007

Transparency when things go wrong: physician attitudes about reporting medical errors to patients, peers, and institutions.

March 18, 2015

The value of learning from near misses to improve patient safety: a scoping review.

January 25, 2023

Feeling unsafe in the healthcare setting: patients' perspectives.

March 8, 2017

Healthcare professionals' views of smart glasses in intensive care: a qualitative study.

February 7, 2018

The social dimensions of safety incident reporting in maternity care: the influence of working relationships and group processes.

December 12, 2012

From tragedy to advocacy.

September 30, 2009

Changing course.

November 18, 2009

Still hard to share. PSOs making progress but still face tech hurdles.

November 4, 2009

AHRQ presses on: no rule yet, but agency taps 10 safety organizations.

November 26, 2008

Certified registered nurse anesthetist perceptions of factors impacting patient safety.

April 26, 2017

Validation of hospital administrative dataset for adverse event screening.

June 30, 2010

Breaking the mould in patient safety.

July 15, 2009

Error in intensive care: psychological repercussions and defense mechanisms among health professionals.

October 29, 2014

The relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: analysis of administrative data.

April 8, 2009

Analyzing and discussing human factors affecting surgical patient safety using innovative technology: creating a safer operating culture.

August 31, 2022

Understanding the healthcare workplace learning culture through safety and dignity narratives: a UK qualitative study of multiple stakeholders' perspectives.

June 12, 2019

Implementing a distraction-free practice with the Red Zone Medication Safety initiative.

June 8, 2016

Imperfect practice makes perfect: error management training improves transfer of learning.

April 26, 2017

'Even now it makes me angry': health care students' professionalism dilemma narratives.

August 6, 2014

An in situ simulation program: a quantitative and qualitative prospective study identifying latent safety threats and examining participant experiences.

January 20, 2021

Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.

April 13, 2022

The ‘new view’ of human error. Origins, ambiguities, successes and critiques.

September 14, 2022

Barriers to staff adoption of a surgical safety checklist.

November 30, 2011

Health care workers' experiences of workplace incidents that posed a risk of patient and worker injury: a critical incident technique analysis.

July 14, 2021

Higher rates of misdiagnosis in pediatric patients versus adults hospitalized with imported malaria.

November 26, 2014

Organizational perspectives of nurse executives in 15 hospitals on the impact and effectiveness of rapid response teams.

April 19, 2017

Levels of reflective thinking and patient safety: an investigation of the mechanisms that impact on student learning in a single cohort over a 5 year curriculum.

August 13, 2014

Nurses' perceptions of an electronic patient record from a patient safety perspective: a qualitative study.

August 17, 2011

Communication matters when it comes to adverse events: associations of adverse events during implant treatment with patients' communication quality and trust assessments.

March 15, 2023

A review of educational philosophies as applied to radiation safety training at medical institutions.

May 24, 2006

Purchase of prescription medicines via social media: a survey-based study of prevalence, risk perceptions, and motivations.

October 27, 2021

COVID-19 and open notes: a new method to enhance patient safety and trust.

July 7, 2021

Miscount incidents: a novel approach to exploring risk factors for unintentionally retained surgical items.

October 2, 2013

Review of computerized physician handoff tools for improving the quality of patient care.

December 12, 2012

Adverse health events related to self-medication practices among elderly: a systematic review.

May 31, 2017

A systems approach to address the impact of second victim phenomenon.

December 9, 2020

Trends in the prevalence of intraoperative adverse events at two academic hospitals after implementation of a mandatory reporting system.

April 25, 2018

Empowering patients and reducing inequities: is there potential in sharing clinical notes?

April 15, 2020

Medication errors during patient transitions into nursing homes: characteristics and association with patient harm.

January 30, 2005

Automated drug dispensing system reduces medication errors in an intensive care setting.

September 29, 2010

Good and bad reasons: the Swiss cheese model and its critics.

August 12, 2020

Innovative teaching in situational awareness.

June 24, 2015

Accuracy of medication documentation in hospital discharge summaries: a retrospective analysis of medication transcription errors in manual and electronic discharge summaries.

November 4, 2009

Human cognition and the dynamics of failure to rescue: the Lewis Blackman case.

May 22, 2013

An observational study of medication administration errors in old-age psychiatric inpatients.

July 4, 2007

Prescription errors in psychiatry - a multi-centre study.

September 6, 2006

Anticoagulant medication errors in nursing homes: characteristics, causes, outcomes, and association with patient harm.

August 7, 2013

Online medication error graphic reports: a pilot in North Carolina nursing homes.

June 15, 2011

Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study.

October 18, 2017

Costs and consequences associated with misdiagnosed lower extremity cellulitis.

November 23, 2016

Missed nursing care during the COVID-19 pandemic: a comparative observational study.

July 21, 2021

Missed nursing care in the critical care unit, before and during the COVID-19 pandemic: a comparative cross-sectional study.

June 22, 2022

ACR guidance document on MR safe practices: 2013.

March 21, 2013

A review of medication administration errors reported in a large psychiatric hospital in the United Kingdom.

January 4, 2006

Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II.

February 10, 2010

Five topics health care simulation can address to improve patient safety: results from a consensus process.

April 27, 2016

Effect of social influences on pharmacists' intention to report adverse drug events.

October 17, 2012

Impact of adverse events on outcomes in intensive care unit patients.

July 2, 2008

Evaluation of clinical practice guidelines on fall prevention and management for older adults: a systematic review.

January 12, 2022

COVID-19 increased the risk of ICU-acquired bloodstream infections: a case-cohort study from the multicentric OUTCOMEREA network.

March 17, 2021

The effect of workload on infection risk in critically ill patients.

January 17, 2007

Nursing perception of the impact of medication carts on patient safety and ergonomics in a teaching health care center.

August 8, 2012

Higher incidence of adverse events in isolated patients compared with non-isolated patients: a cohort study.

November 18, 2020

Patterns in nursing home medication errors: disproportionality analysis as a novel method to identify quality improvement opportunities.

December 15, 2010

Patient safety culture improves during an in situ simulation intervention: a repeated cross-sectional intervention study at two hospital sites.

March 25, 2021

For children admitted to hospital, what interventions improve medication safety on ward rounds?

March 1, 2023

Novel approach to cardiac alarm management on telemetry units.

February 19, 2014

Distractions in the operating room: a survey of the healthcare team.

April 5, 2023

Impact of morbidity and mortality conferences on analysis of mortality and critical events in intensive care practice.

March 24, 2010

Adverse event reviews in healthcare: what matters to patients and their family? A qualitative study exploring the perspective of patients and family.

June 1, 2022

Improving surgical complications and patient safety at the nation's largest military hospital: an analysis of National Surgical Quality Improvement Program data.

March 29, 2017

Missed breast cancer: effects of subconscious bias and lesion characteristics.

August 5, 2020

E-prescribing, efficiency, quality: lessons from the computerization of UK family practice.

September 20, 2006

Related Resources

Using Failure Mode, Effect and Criticality Analysis to improve safety in the cancer treatment prescription and administration process.

March 8, 2023

Annual Perspective

Annual Perspective: Topics in Medication Safety

March 31, 2022

Healthcare failure mode and effect analysis in the chemotherapy preparation process.

November 17, 2021

Geriatric medication reconciliation in the home setting.

July 21, 2021

Use of therapeutic outcomes monitoring method for performing of pharmaceutical care in oncology patients.

April 28, 2021

WebM&M Cases

The Impact of Communication on Medication Errors

March 15, 2021

Patient Safety Primers

Medication Administration Errors

March 12, 2021

Nurse burnout predicts self-reported medication administration errors in acute care hospitals.

January 20, 2021

What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff.

January 23, 2019

Fixed-dose combination antihypertensives and risk of medication errors.

October 3, 2018

Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study.

March 21, 2018

Safety and efficiency of a new generic package labelling: a before and after study in a simulated setting.

May 17, 2017

Separate medication preparation rooms reduce interruptions and medication errors in the hospital setting: a prospective observational study.

February 15, 2017

The problem with medication reconciliation.

August 31, 2016

Partnered pharmacist charting on admission in the general medical and emergency short-stay unit—a cluster-randomised controlled trial in patients with complex medication regimens.

August 17, 2016

Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.

June 8, 2016

Medication competency of nurses according to theoretical and drug calculation online exams: a descriptive correlational study.

March 30, 2016

The perceptions of nurses towards barriers to the safe administration of medicines in mental health settings.

February 3, 2016

Medication reconciliation at admission and discharge: an analysis of prevalence and associated risk factors.

September 23, 2015

FDA Drug Safety Communication: FDA warns about prescribing and dispensing errors resulting from brand name confusion with antidepressant Brintellix (vortioxetine) and antiplatelet Brilinta (ticagrelor).

August 12, 2015

Fentanyl transdermal system (marketed as Duragesic) information.

July 10, 2015

Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study.

February 4, 2015

Implementation of standardized dosing units for I.V. medications.

January 21, 2015

The legibility of prescription medication labelling in Canada: moving from pharmacy-centred to patient-centred labels.

July 30, 2014

Quiet please! Drug round tabards: are they effective and accepted? A mixed method study.

July 9, 2014

How studying human factors improves patient safety.

April 16, 2014

The effect of a clinical pharmacist-led training programme on intravenous medication errors: a controlled before and after study.

April 2, 2014

Potential inaccuracy of electronically transmitted medication history information used for medication reconciliation.

February 26, 2014

An evaluation of a collaborative, safety focused, nurse–pharmacist intervention for improving the accuracy of the medication history.

November 20, 2013

Communicating medication changes to community pharmacy post-discharge: the good, the bad, and the improvements.

September 4, 2013

See More About The Topic

Nurses

Pharmacists

Nurse Managers

Quality and Safety Professionals

Pharmacy

Tablet-splitting: a common yet not so innocent practice.

Medication Administration Errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Tablet-splitting: a common yet not so innocent practice.

Medication Administration Errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Submit Your Case

Continue as a Guest

Continue Logged In

Submit Your Case

Continue as a Guest

Already have a PSNet

Account?

New Users

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site