Accurately administering oral medication to children isn't child's play

Beckett, V. L.; Tyson, Luke D.; Carroll, Daniel; Gooding, Nigel; Kelsall, AW

doi:10.1136/archdischild-2012-301850

Cited by 32 publications

(29 citation statements)

References 18 publications

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“…3 Multiple studies have proven the ability of parents to accurately measure medication doses with oral syringes. 1,16,17 Given the variability of potential doses in prescription oral, liquid products, such as antibiotics, an oral syringe may be the most reasonable measuring device to be included with these products.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Measuring Devices Packaged With Prescription Oral Liquid Medications

Meyers

2016

The Journal of Pediatric Pharmacology and Therapeutics

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Section: Discussionmentioning

confidence: 99%

Evaluation of Measuring Devices Packaged With Prescription Oral Liquid Medications

Meyers

2016

The Journal of Pediatric Pharmacology and Therapeutics

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“…6,8,9 Studies have examined errors associated with parental health literacy and numeracy and their ability to correctly measure doses of medications. [10][11][12][13][14] Numerous studies have investigated the dosing inaccuracies of various medication administration devices, such as an oral syringe, dosing spoon, dropper, and dosing cup, 11,[15][16][17][18][19] whereas others have examined the variability of labeling and packaging of medications. 12,20,21 Most studies have been based on relatively small convenience samples, and only a few have used statewide or national databases.…”

Section: Methodsmentioning

confidence: 99%

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

et al. 2014

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OBJECTIVE: To investigate out-of-hospital medication errors among young children in the United States. METHODS: Using data from the National Poison Database System, a retrospective analysis of out-of-hospital medication errors among children <6 years old from 2002 through 2012 was conducted. RESULTS: During 2002–2012, 696 937 children <6 years experienced out-of-hospital medication errors, averaging 63 358 episodes per year, or 1 child every 8 minutes. The average annual rate of medication errors was 26.42 per 10 000 population. Cough and cold medication errors decreased significantly, whereas the number (42.9% increase) and rate (37.2% increase) of all other medication errors rose significantly during the 11-year study period. The number and rate of medication error events decreased with increasing child age, with children <1 year accounting for 25.2% of episodes. Analgesics (25.2%) were most commonly involved in medication errors, followed by cough and cold preparations (24.6%). Ingestion accounted for 96.2% of events, and 27.0% of medication errors were attributed to inadvertently taking or being given medication twice. Most (93.5%) cases were managed outside of a health care facility; 4.4% were treated and released from a health care facility; 0.4% were admitted to a non–critical care unit; 0.3% were admitted to a critical care unit; and 25 children died. CONCLUSIONS: This is the first comprehensive study to evaluate the epidemiologic characteristics of out-of-hospital medication errors among children <6 years of age on a national level. Increased efforts are needed to prevent medication errors, especially those involving non–cough and cold preparations, among young children.

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“…Wrong dosing of paediatric liquid medications is exceedingly common, with a considerable proportion of caregivers (10–90%) measuring the doses incorrectly . Generally, the use of calibrated oral syringes caused fewer errors as compared with other devices including dosing cups, household spoons and droppers . However, Yin et al .…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…[13][14][15][16][17][18] Generally, the use of calibrated oral syringes caused fewer errors as compared with other devices including dosing cups, household spoons and droppers. [14][15][16][17]19,20 However, Yin et al 16 found that approximately 25% of the caregivers in a New York public hospital measured liquid medications with deviations of greater than 40% from prescribed doses, despite the measuring devices used. In addition, confusion with the measurement units and product concentrations has led to dosing errors.…”

Section: What Is Known and Objectivementioning

confidence: 99%

Using pictograms to assist caregivers in liquid medication administration: a systematic review

et al. 2015

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SUMMARYWhat is known and objective: It has been reported that more than 80% of out-of-hospital medication errors among the young children involve liquid formulations. The usefulness of pictorial aids to improve communication of medication instructions has not been extensively investigated for child health. The objective of this study was to determine the effectiveness of pictorial aids used to assist caregivers in the administration of liquid medications. Methods: MEDLINE, CINAHL, PsycINFO, ScienceDirect, Scopus and the Cochrane Library were searched for articles published up to February 2015. Studies that used pictorial aids with liquid medications and measured at least one of the following outcomes were included: dosing accuracy, comprehension of medication instructions, recall of information and adherence of caregivers. Two authors independently selected studies, extracted data and assessed methodological quality of studies using the Cochrane Collaboration's tool. Results and discussion: Five experimental studies (four hospital based and one community based) with a total of 962 participants were included. A wide range of liquid formulations were studied, including both prescription and over-the-counter medications. The existing findings suggest that pictographic interventions reduced dosing errors, enhanced comprehension and recall of medication instructions and improved adherence of caregivers. Incorporating pictorial aids into verbal medication counselling or text-based instructions was more beneficial than using the single approach alone. Mixed results were identified for the relationship between health literacy of caregivers and effectiveness of pictorial aids. What is new and conclusion: The evidence remains limited due to the small number of studies found and variations in methodological quality. This review suggests that pictorial aids might be potential interventions, but more high-quality studies are needed to support the routine use of any pictogram-based materials with liquid medications in the clinical settings. WHAT IS KNOWN AND OBJECTIVELiquids are often the preferred form of oral medication delivery for young children and infants. These formulations are usually combined with pleasant-tasting excipients and easier to swallow.

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Accurately administering oral medication to children isn't child's play

Cited by 32 publications

References 18 publications

Evaluation of Measuring Devices Packaged With Prescription Oral Liquid Medications

Evaluation of Measuring Devices Packaged With Prescription Oral Liquid Medications

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

Using pictograms to assist caregivers in liquid medication administration: a systematic review

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