Medication Errors and How Parent's Can Prevent Them
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Special needs children often require multiple medications, multiple times a day….a recipe for complicated drug regiments. For many of these children, their medications are their lifeline. It is vital to give medications exactly as directed.
Dr. Kathleen E. Walsh, assistant professor of pediatrics at University of Massachusetts Medical School, led a new study that suggests parent's frequently make mistakes while giving meds to their chronically ill children.
The research team went into the homes of 83 different chronically ill children ages 6 months to 20-years-old that suffered from cancer, sickle cell anemia, epilepsy, etc.. Altogether, the researchers watched 166 drugs being administered by the parent, caregiver, or children themselves. They also checked over 500 medications. Two doctors then followed up to analyze the administration and medication correctness. 128 medication errors were found. Of the 128 medication errors noted, at least 73 could have seriously hurt the child, and 10 actually did injure the child. One mistake involved a serious overdose when a chemotherapy dosing label directed six tablets a day. The child was actually supposed to have seven tablets a week. However, simple mistakes, like not using the correct syringe or pill cutter, can result in the child getting too little or too much of a medication.
The study also noted that these medication errors are not attributed to lack of higher education. In fact, 49% of the medication administers had at least a bachelor’s degree.
As a nurse, I can attest that parent’s are not alone in medication error statistics. Even the most careful medication administer can have a mistake. However, many medication errors are preventable. Here are some tips to help prevent medication errors:
1. Make sure that the doctor and pharmacist gives you written instructions that include information such as dosage, how often the medication is given, if there is a specific time of day to give the medication, the route that the medication is to be given (by mouth, injection, IV, G-tube, rectally), drug interactions, storage instructions, whether the medication can be crushed if needed, and other medication specific information.
2. If you have any pause or question about the medication, the dosage, or the directions….contact the prescribing doctor. There is no such thing as a stupid question. Make sure you have complete clarity about the medication before giving it.
3. Organize medications. Assign a different area in the home for each person’s medications, and keep all of each person‘s medications together.
4. If you are giving your child multiple medications…multiple times a day, make yourself a medication administration record. It doesn’t have to be anything fancy. List each medicine on a line; include the dose directions, strength, and what the medication is for beside each medication. For example, “Humalog insulin 2 units subcutaneous 7 A.M. and 7 P.M. for diabetes.” If the medication requires an additional action such as taking a blood sugar or blood pressure, then write that action on a separate line, and record the results. The medication administration record should be brought with you to all relevant doctor appointments.
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5. You shouldn’t actually be using a tablespoon or teaspoon to administer medications. Use a syringe or dosage cup with clear and easy to read markings. Use a pill crusher to crush medicines and a pill splitter to cut pills. Rinse and dry the measuring device out daily to prevent medication from crusting inside and altering the dosage.
6. Do not leave it to the child to take their medication. Many medications have side effects that deter the child from wanting to take the medication. Rather than arguing with you or voicing their concerns, many children just don’t take the medication. Even older teens should have oversight.
7. Check, check, and check again. It doesn’t matter how familiar you are with your child’s medicine regiment. Check the label when you begin. Check the medication label again when you sign your medication administration record. Check the label a third time before you give the medication. You are checking to make sure you have the right med, the right dose, and at the right time.
Dr. Kathleen E. Walsh, assistant professor of pediatrics at University of Massachusetts Medical School, led a new study that suggests parent's frequently make mistakes while giving meds to their chronically ill children.
The research team went into the homes of 83 different chronically ill children ages 6 months to 20-years-old that suffered from cancer, sickle cell anemia, epilepsy, etc.. Altogether, the researchers watched 166 drugs being administered by the parent, caregiver, or children themselves. They also checked over 500 medications. Two doctors then followed up to analyze the administration and medication correctness. 128 medication errors were found. Of the 128 medication errors noted, at least 73 could have seriously hurt the child, and 10 actually did injure the child. One mistake involved a serious overdose when a chemotherapy dosing label directed six tablets a day. The child was actually supposed to have seven tablets a week. However, simple mistakes, like not using the correct syringe or pill cutter, can result in the child getting too little or too much of a medication.
The study also noted that these medication errors are not attributed to lack of higher education. In fact, 49% of the medication administers had at least a bachelor’s degree.
As a nurse, I can attest that parent’s are not alone in medication error statistics. Even the most careful medication administer can have a mistake. However, many medication errors are preventable. Here are some tips to help prevent medication errors:
1. Make sure that the doctor and pharmacist gives you written instructions that include information such as dosage, how often the medication is given, if there is a specific time of day to give the medication, the route that the medication is to be given (by mouth, injection, IV, G-tube, rectally), drug interactions, storage instructions, whether the medication can be crushed if needed, and other medication specific information.
2. If you have any pause or question about the medication, the dosage, or the directions….contact the prescribing doctor. There is no such thing as a stupid question. Make sure you have complete clarity about the medication before giving it.
3. Organize medications. Assign a different area in the home for each person’s medications, and keep all of each person‘s medications together.
4. If you are giving your child multiple medications…multiple times a day, make yourself a medication administration record. It doesn’t have to be anything fancy. List each medicine on a line; include the dose directions, strength, and what the medication is for beside each medication. For example, “Humalog insulin 2 units subcutaneous 7 A.M. and 7 P.M. for diabetes.” If the medication requires an additional action such as taking a blood sugar or blood pressure, then write that action on a separate line, and record the results. The medication administration record should be brought with you to all relevant doctor appointments.
5. You shouldn’t actually be using a tablespoon or teaspoon to administer medications. Use a syringe or dosage cup with clear and easy to read markings. Use a pill crusher to crush medicines and a pill splitter to cut pills. Rinse and dry the measuring device out daily to prevent medication from crusting inside and altering the dosage.
6. Do not leave it to the child to take their medication. Many medications have side effects that deter the child from wanting to take the medication. Rather than arguing with you or voicing their concerns, many children just don’t take the medication. Even older teens should have oversight.
7. Check, check, and check again. It doesn’t matter how familiar you are with your child’s medicine regiment. Check the label when you begin. Check the medication label again when you sign your medication administration record. Check the label a third time before you give the medication. You are checking to make sure you have the right med, the right dose, and at the right time.
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