Yin H Shonna, Dreyer Benard P, Moreira Hannah A, van Schaick Linda, Rodriguez Luis, Boettger Susanne, Mendelsohn Alan L
Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY.
Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY.
Acad Pediatr. 2014 May-Jun;14(3):262-70. doi: 10.1016/j.acap.2014.01.003.
To examine the degree to which recommended provider counseling strategies, including advanced communication techniques and dosing instrument provision, are associated with reductions in parent liquid medication dosing errors.
Cross-sectional analysis of baseline data on provider communication and dosing instrument provision from a study of a health literacy intervention to reduce medication errors. Parents whose children (<9 years) were seen in 2 urban public hospital pediatric emergency departments (EDs) and were prescribed daily dose liquid medications self-reported whether they received counseling about their child's medication, including advanced strategies (teachback, drawings/pictures, demonstration, showback) and receipt of a dosing instrument. The primary dependent variable was observed dosing error (>20% deviation from prescribed). Multivariate logistic regression analyses were performed, controlling for parent age, language, country, ethnicity, socioeconomic status, education, health literacy (Short Test of Functional Health Literacy in Adults); child age, chronic disease status; and site.
Of 287 parents, 41.1% made dosing errors. Advanced counseling and instrument provision in the ED were reported by 33.1% and 19.2%, respectively; 15.0% reported both. Advanced counseling and instrument provision in the ED were associated with decreased errors (30.5 vs. 46.4%, P = .01; 21.8 vs. 45.7%, P = .001). In adjusted analyses, ED advanced counseling in combination with instrument provision was associated with a decreased odds of error compared to receiving neither (adjusted odds ratio 0.3; 95% confidence interval 0.1-0.7); advanced counseling alone and instrument alone were not significantly associated with odds of error.
Provider use of advanced counseling strategies and dosing instrument provision may be especially effective in reducing errors when used together.
探讨推荐的医疗服务提供者咨询策略，包括先进的沟通技巧和提供配药工具，在多大程度上与减少家长液体药物给药错误相关。
对一项旨在减少用药错误的健康素养干预研究中的医疗服务提供者沟通和配药工具提供的基线数据进行横断面分析。在两家城市公立医院儿科急诊科就诊且其子女（<9岁）被开具每日剂量液体药物的家长，自行报告他们是否接受了关于孩子用药的咨询，包括先进策略（反馈教学、绘图/图片、示范、回示）以及是否收到配药工具。主要因变量是观察到的给药错误（与规定剂量偏差>20%）。进行多因素逻辑回归分析，控制家长的年龄、语言、国家、种族、社会经济地位、教育程度、健康素养（成人功能性健康素养简短测试）；孩子的年龄、慢性病状况；以及就诊地点。
在287名家长中，41.1%出现给药错误。分别有33.1%和19.2%的家长报告在急诊科接受了先进咨询和获得了配药工具；15.0%的家长报告两者都有。在急诊科接受先进咨询和获得配药工具与错误减少相关（30.5%对46.4%，P = 0.01；21.8%对45.7%，P = 0.001）。在调整分析中，与既未接受先进咨询也未获得配药工具相比，急诊科的先进咨询与配药工具相结合与错误几率降低相关（调整后的优势比为0.3；95%置信区间为0.1 - 0.7）；单独的先进咨询和单独的配药工具与错误几率无显著关联。
医疗服务提供者使用先进咨询策略和提供配药工具一起使用时，在减少错误方面可能特别有效。
