Yin H Shonna, Mendelsohn Alan L, Wolf Michael S, Parker Ruth M, Fierman Arthur, van Schaick Linda, Bazan Isabel S, Kline Matthew D, Dreyer Benard P
Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, 550 First Ave, NBV 8S4-11, New York, NY 10016, USA.
Arch Pediatr Adolesc Med. 2010 Feb;164(2):181-6. doi: 10.1001/archpediatrics.2009.269.
To assess parents' liquid medication administration errors by dosing instrument type and to examine the degree to which parents' health literacy influences dosing accuracy.
Experimental study.
Interviews conducted in a public hospital pediatric clinic in New York, New York, between October 28, 2008, and December 24, 2008.
Three hundred two parents of children presenting for care were enrolled.
Parents were observed for dosing accuracy (5-mL dose) using a set of standardized instruments (2 dosing cups [one with printed calibration markings, the other with etched markings], dropper, dosing spoon, and 2 oral syringes [one with and the other without a bottle adapter]).
The percentages of parents dosing accurately (within 20% of the recommended dose) were 30.5% using the cup with printed markings and 50.2% using the cup with etched markings, while more than 85% dosed accurately with the remaining instruments. Large dosing errors (>40% deviation) were made by 25.8% of parents using the cup with printed markings and 23.3% of parents using the cup with etched markings. In adjusted analyses, cups were associated with increased odds of making a dosing error (>20% deviation) compared with the oral syringe (cup with printed markings: adjusted odds ratio [AOR] = 26.7; 95% confidence interval [CI], 16.8-42.4; cup with etched markings: AOR = 11.0; 95% CI, 7.2-16.8). Compared with the oral syringe, cups were also associated with increased odds of making large dosing errors (cup with printed markings: AOR = 7.3; 95% CI, 4.1-13.2; cup with etched markings: AOR = 6.3; 95% CI, 3.5-11.2). Limited health literacy was associated with making a dosing error (AOR = 1.7; 95% CI, 1.1-2.8).
Dosing errors by parents were highly prevalent with cups compared with droppers, spoons, or syringes. Strategies to reduce errors should address both accurate use of dosing instruments and health literacy.
按给药器具类型评估家长给予液体药物时的用药错误情况，并研究家长的健康素养对给药准确性的影响程度。
实验性研究。
2008年10月28日至2008年12月24日期间在纽约市一家公立医院儿科诊所进行访谈。
招募了302名带孩子前来就诊的家长。
使用一套标准化器具（2个量杯[一个有印刷校准标记，另一个有蚀刻标记]、滴管、药匙和2个口服注射器[一个有瓶适配器，另一个没有]）观察家长给予5毫升剂量药物时的给药准确性。
使用有印刷标记量杯的家长给药准确（在推荐剂量的20%范围内）的比例为30.5%，使用有蚀刻标记量杯的为50.2%，而使用其余器具给药准确的比例超过85%。使用有印刷标记量杯的家长中有25.8%、使用有蚀刻标记量杯的家长中有23.3%出现了较大的给药错误（偏差>40%）。在调整分析中，与口服注射器相比，量杯出现给药错误（偏差>20%）的几率增加（有印刷标记量杯：调整后的优势比[AOR]=26.7；95%置信区间[CI]，16.8 - 42.4；有蚀刻标记量杯：AOR = 11.0；95% CI，7.2 - 16.8）。与口服注射器相比，量杯出现较大给药错误的几率也增加（有印刷标记量杯：AOR = 7.3；95% CI，4.1 - 13.2；有蚀刻标记量杯：AOR = 6.3；9,5% CI，3.5 - 11.2）。健康素养有限与出现给药错误相关（AOR = 1.7；95% CI，1.1 - 2.8）。
与滴管、药匙或注射器相比，家长使用量杯时给药错误非常普遍。减少错误的策略应同时涉及给药器具的正确使用和健康素养。
