Tall Man Lettering on syringe labels: How capital letters improve patient safety
Look-alike, sound-alike drug names can lead to medication errors and therefore endanger patient safety. An eye tracking study now found evidence that capitalization in drug names shifts visual attention and thus helps distinguishing drugs with similar names.
Tall man lettering (TML) is a coding method using capitalisation of distinct text parts in drug names to facilitate the differentiation of medication labels. Although TML is recommended by several institutions, the evidence on the use of TML and its influence on visual attention is limited.
An interprofessional research group from ETH and USZ therefore conducted an eye tracking study with 30 critical care nurses. In a simulated setting, TML coding of syringe labels led to a significant decrease in the error rate. Eye tracking further showed that TML affects visual attention, resulting in longer dwell time, more and longer fixations on the drug name as well as more frequent revisits compared with non-TML-coded labels.
Detailed data analysis also revealed that these effects were stronger for labels using TML in the mid-to-end position of the drug name: an insight that might help to improve drug label designs and thus patient safety.
The full publication by Lohmeyer et al. is avaiable as open access on external pageBMJ Quality and Saftey.
Update: The paper Effects of tall man lettering on the visual behaviour of critical care nurses while identifying syringe drug labels: a randomised in situ simulation by Lohmeyer et al. has been honored with the Q-Award 2022. Congratulations to the authors!
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