Improving safety in the operating room: Medication icon labels increase visibility and discrimination

Appl Ergon. 2022 Oct;104:103831. doi: 10.1016/j.apergo.2022.103831. Epub 2022 Jun 16.


Misreading labels, syringes, and ampoules is reported to make up a 54.4% of medication administration errors. The addition of icons to medication labels in an operating room setting could add additional visual cues to the label, allowing for improved discrimination, visibility, and easily processed information that might reduce medication administration errors. A multi-disciplinary team proposed a method of enhancing visual cues and visibility of medication labels applied to vasoactive medication infusions by adding icons to the labels. Participants were 1.12 times more likely to correctly identify medications from farther away (p < 0.001, AOR = 1.12, 95% CI: 1.02, 1.22) with icons. When icons were present, participants were 2.16 times more likely to be more confident in their identifications (p < 0.001, AOR = 2.16, 95%CI: 1.80, 2.57). Carefully designed icons may offer an additional method for identifying medications, and thus reducing medication administration errors.

Keywords: Human factors; Icons; Medication errors; Medication labeling.

MeSH terms

  • Drug Labeling
  • Humans
  • Medication Errors* / prevention & control
  • Operating Rooms*
  • Syringes