Parental Experiences of Medication Administration to Children at Home and Understanding of Adverse Drug Events

10.1097/jnr.0000000000000080

Mi-Ae You；Su-Min Nam；Youn-Jung Son

child ； medication administration ； medication error ； parent ； safety

The Journal of Nursing Research

23卷3期（2015 / 09 / 01）

189 - 196

英文

Background: Medication administration errors are the most common type of error in pediatricmedicine. Preventing medication errors is an important part of ensuring safe and quality patient care for pediatric patients. Few studies have described this issue from the perspective of the parents of pediatric patients. Purpose: This study describes parents' administration of medication to their children at home and the understanding of these parents of adverse drug events (ADEs). Methods: A cross-sectional survey design was used to gather data from 179 parents of pediatric patients at two pediatric units at a hospital and three children's daycare centers in Korea. Data were collected from July to August 2012 using a self-reported questionnaire. Results: Participants reported administering antipyretics (94.4%), decongestants (89.4%), and antibiotics (77.7%) to their children at home. The major source of medication information was instruction sheets. Parents more commonly used dosing cups (43.6%) and droppers (32.9%) when administering liquid medication to children. Furthermore, 12.3% of the children experienced ADEs. Only 48% of the participants were provided information on ADEs, 15.1% were unsure about the recommended dosage, and 11.2% were unsure of the recommended method for administering the medication. Analysis of variance and post hoc tests showed that level of parental education and monthly income each had a significant impact on participant understanding of ADEs. Conclusions/Implications for Practice: This study suggests that parents should be educated about ways to avoid common medication errors in children. In addition, in the case of low-income families, home visits should be carried out to understand how to reduce home medication errors and provide drug-related information to parents. Strategies are needed to reduce pediatric home medication errors and minimize ADEs and to provide medication information to parents.

1. Bailey, S. C.,Pandit, A. U.,Yin, S.,Federman, A.,Davis, T. C.,Parker, R. M.,Wolf, M. S.(2009).Predictors of misunderstanding pediatric liquid medication instructions.Family Medicine,41(10),715-721.
2. Bilenko, N.,Tessler, H.,Okbe, R.,Press, J.,Gorodischer, R.(2006).Determinants of antipyretic misuse in children up to 5 years of age: A cross-sectional study.Clinical Therapeutics,28(5),783-793.
3. Bowling, A.(1997).Research methods in health: Investigating health and health services.Philadelphia, PA:Open University Press.
4. Chan, G. C.,Tang, S. F.(2006).Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia.Singapore Medical Journal,47(4),266-270.
5. Davis, T. C.,Wolf, M. S.,Bass, P. F.,Thompson, J. A.,Tilson, H. H.,Neuberger, M.,Parker, R. M.(2006).Literacy and misunder-standing prescription drug labels.Annals of Internal Medicine,145(12),887-894.
6. Frush, K. S.,Luo, X.,Hutchinson, P.,Higgins, J. N.(2004).Evaluation of a method to reduce over-the-counter medication dosing error.Archives of Pediatrics & Adolescent Medicine,158(7),620-624.
7. Gonzales, K.(2010).Medication administration errors and the pediatric population: A systematic search of the literature.Journal of Pediatric Nursing,25(6),555-565.
8. Holdsworth, M. T.,Fichtl, R. E.,Behta, M.,Raisch, D. W.,Mendez-Rico, E.,Adams, A.,Greenwald, B. M.(2003).Incidence and impact of adverse drug events in pediatric inpatients.Archives of Pediatrics and Adolescents Medicine,157(1),60-65.
9. Ji, E. H.(2004).Seoul, Republic of Korea,Sookmyung Women's University.
10. John, J. M.(2005).Preventing medication errors at home.Journal of Pharmacy Practice,18(3),141-144.
11. Kaushal, R.,Goldmann, D. A.,Keohane, C. A.,Christino, M.,Honour, M.,Hale, A. S.,Bates, D. W.(2007).Adverse drug events in pediatric outpatients.Ambulatory Pediatrics,7(5),383-389.
12. Kozer, E.,Berkovitch, M.,Koren, G.(2006).Medication errors in children.Pediatric Clinics of North America,53(6),1155-1168.
13. Li, S. F.,Lacher, B.,Crain, E. F.(2000).Acetaminophen and ibuprofen dosing by parents.Pediatric Emergency Care,16(6),394-397.
14. Lindell-Osuagwu, L.,Sepponen, K.,Farooqui, S.,Kokki, H.,Hämeen-Anttila, K.,Vainio, K.(2013).Parental reporting of adverse drug events and other drug-related problems in children in Finland.European Journal of Clinical Pharmacology,69(4),985-994.
15. Miller, M. R.,Robinson, K. A.,Lubomski, L. H.,Rinke, M. L.,Pronovost, P. J.(2007).Medication errors in paediatric care: A systematic review of epidemiology and an evaluation of evidence supporting reduction strategy recommendations.Quality & Safety,16(2),116-126.
16. NamGoong, B. R.,Sohn, H. S.,Choi, K. E.,Shin, H. T.(2012).Retrospective drug utilization review on the same-day multiple prescriptions for pediatrics outpatients.Korean Journal of Clinical Pharmacy,22(1),73-80.
17. Nebeker, J. R.,Barach, P.,Samore, M. H.(2004).Clarifying adverse drug events: A clinician's guide to terminology, docu-mentation, and reporting.Annals of Internal Medicine,140(10),795-801.
18. Parimi, N.,Pinto Pereira, L. M.,Prabhakar, P.(2004).Caregivers'practices, knowledge and beliefs of antibiotics in paediatric upper respiratory tract infections in Trinidad and Tobago: A cross-sectional study.BMC Family Practice,5(28),1-8.
19. Payne, C. H.,Smith, C. R.,Newkirk, L. E.,Hicks, R. W.(2007).Pediatric medication errors in the postanesthesia care unit: Analysis of MEDMARX data.AORN Journal,85(4),731-740.
20. Shefrin, A. E.,Goldman, R. D.(2009).Use of over-the-counter cough and cold medications in children.Canadian Family Medicine,55(11),1081-1083.
21. Shrank, W. H.,Agnew-Blais, J.,Choudhry, N. K.,Wolf, M. S.,Kesselheim, A. S.,Avorn, J.,Shekelle, P.(2007).The vari-ability and quality of medication container labels.Archives of Internal Medicine,167(16),1760-1765.
22. Smyth, R. M. D.,Gargon, E.,Kirkham, J.,Cresswell, L.,Golder, S.,Smyth, R.,Ross, J. S.(2012).Adverse drug reactions in children-systematic review.PloS ONE,7(3),e24061.
23. Sobhani, P.,Christopherson, J.,Ambrose, P. J.,Corelli, R. L.(2008).Accuracy of oral liquid measuring devices: Compar-ison of dosing cup and oral dosing syringe.The Annals of Pharmacotherapy,42(1),56-52.
24. Wallace, L. S.,Keenum, A. J.,DeVoe, J. E.(2010).Evaluation of consumer medical information and oral liquid measuring devices accompanying pediatric prescriptions.Academic Pediatrics,10(4),224-227.
25. Walsh, K. E.,Mazor, K. M.,Stille, C. J.,Torres, I.,Wagner, J. L.,Moretti, J.,Gurwitz, J. H.(2011).Medication errors in the homes of children with chronic conditions.Archives of Disease Childhood,96(6),581-586.
26. Yin, H. S.,Dreyer, B. P.,Foltin, G.,van Schaick, L.,Mendelsohn, A. L.(2007).Association of low caregiver health literacy with reported use of nonstandardized dosing instruments and lack of knowledge of weight-based dosing.Ambulatory Pediatrics,7(4),292-298.
27. Yin, H. S.,Dreyer, B. P.,van Schaick, L.,Foltin, G. L.,Dinglas, C.,Mendelsohn, A. L.(2008).Randomized controlled trial of a pictogram-based intervention to reduce liquid medication dosing errors and improve adherence among caregivers of young children.Archives of Pediatrics & Adolescent Medicine,162(9),814-822.
28. Yin, H. S.,Mendelsohn, A. L.,Wolf, M. S.,Parker, R. M.,Fierman, A.,van Schaick, L.,Dreyer, B. P.(2010).Parents' medication administration errors: Role of dosing instruments and health literacy.Archives of Pediatrics & Adolescent Medicine,164(2),181-186.
29. Zandieh, S. O.,Goldmann, D. A.,Keohane, C. A.,Yoon, C.,Bates, D. W.,Kaushal, R.(2008).Risk factors in preventable adverse drug events in pediatric outpatients.The Journal of Pediatrics,152(2),225-231.