Cox Elizabeth D, Hansen Kristofer, Rajamanickam Victoria P, Brown Roger L, Rathouz Paul J, Carayon Pascale, DuBenske Lori L, Buel Linda A, Kelly Michelle M
Departments of Pediatrics,
Population Health Sciences.
Hosp Pediatr. 2017 Dec;7(12):716-722. doi: 10.1542/hpeds.2017-0036. Epub 2017 Nov 15.
Many parents report needing to watch over their child's hospital care to prevent mistakes. In this study, we assessed whether needing to watch over care predicts parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections.
At admission, we surveyed 170 parents about their need to watch over care, demographics, and hospitalization factors. At discharge, parents were surveyed about medication awareness and hand hygiene behaviors. Logistic regression was used to examine how parents' need to watch over care predicted each behavior, adjusting for demographics and hospitalization factors.
Thirty-eight percent of parents reported needing to watch over care. Most parents (77%) reported frequently or very frequently asking providers for drug names or doses. Fewer parents asked to check drug or infusion accuracy (29%) or to show or read aloud medication labels (21%). Few parents reminded providers to clean hands (4%), but most stated they would be comfortable asking (82%) and likely to speak up if a provider did not (78%). After adjustment, parents needing to watch over care were significantly more likely to ask providers to check drug or infusion accuracy (adjusted odds ratio = 4.59, 95% confidence interval 2.14-9.94) and for drug name or dose (adjusted odds ratio = 3.04, 95% confidence interval 1.25-7.39).
Parents who report the need to watch over care are more likely to perform behaviors specific to safe medication use (but not hand hygiene) compared with those not reporting this need. Opportunities exist to engage parents as safety partners by leveraging their need to watch over care toward system-level safety initiatives.
许多家长表示需要监督孩子的住院护理情况以防止出现差错。在本研究中,我们评估了监督护理的必要性是否能预测家长采取推荐的安全行为以减少用药错误和医疗保健相关感染的情况。
在入院时,我们对170名家长进行了调查,了解他们监督护理的必要性、人口统计学特征和住院因素。在出院时,对家长进行了用药意识和手部卫生行为的调查。采用逻辑回归分析来研究家长监督护理的必要性如何预测每种行为,并对人口统计学特征和住院因素进行了调整。
38%的家长表示需要监督护理。大多数家长(77%)报告经常或非常频繁地向医护人员询问药物名称或剂量。较少的家长要求检查药物或输液的准确性(29%)或要求展示或大声读出药物标签(21%)。很少有家长提醒医护人员洗手(4%),但大多数家长表示他们愿意询问(82%),并且如果医护人员不洗手,他们很可能会提出意见(78%)。经过调整后,需要监督护理的家长显著更有可能要求医护人员检查药物或输液的准确性(调整后的优势比 = 4.59,95%置信区间 2.14 - 9.94)以及询问药物名称或剂量(调整后的优势比 = 3.04,95%置信区间 1.25 - 7.39)。
与未表示有此需求的家长相比,报告需要监督护理的家长更有可能采取安全用药的特定行为(但不是手部卫生行为)。通过利用家长监督护理的需求推动系统层面的安全举措,有机会让家长成为安全伙伴。