Unit of Measurement Used and Parent Medication Dosing Errors

被引:58
作者
Yin, H. Shonna [1 ,2 ]
Dreyer, Benard P. [1 ,2 ]
Ugboaja, Donna C. [1 ,2 ]
Sanchez, Dayana C. [1 ,2 ]
Paul, Ian M. [3 ]
Moreira, Hannah A. [1 ,2 ]
Rodriguez, Luis [1 ,4 ]
Mendelsohn, Alan L. [1 ,2 ]
机构
[1] NYU, Sch Med, Dept Pediat, New York, NY 10016 USA
[2] Bellevue Hosp Ctr, New York, NY 10016 USA
[3] Penn State Univ, Coll Med, Dept Pediat, Hershey, PA USA
[4] Woodhull Med Ctr, New York, NY USA
基金
美国国家卫生研究院;
关键词
medication errors; health literacy; ambulatory care; health communication; AMERICAN ASSOCIATION; YOUNG-CHILDREN; LIQUID; ACETAMINOPHEN; INSTRUMENTS; DIRECTIONS; KNOWLEDGE; LITERACY;
D O I
10.1542/peds.2014-0395
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BACKGROUND AND OBJECTIVES: Adopting the milliliter as the preferred unit of measurement has been suggested as a strategy to improve the clarity of medication instructions; teaspoon and tablespoon units may inadvertently endorse nonstandard kitchen spoon use. We examined the association between unit used and parent medication errors and whether nonstandard instruments mediate this relationship. METHODS: Cross-sectional analysis of baseline data from a larger study of provider communication and medication errors. English-or Spanish-speaking parents (n = 287) whose children were prescribed liquid medications in 2 emergency departments were enrolled. Medication error defined as: error in knowledge of prescribed dose, error in observed dose measurement (compared to intended or prescribed dose); >20% deviation threshold for error. Multiple logistic regression performed adjusting for parent age, language, country, race/ethnicity, socioeconomic status, education, health literacy (Short Test of Functional Health Literacy in Adults); child age, chronic disease; site. RESULTS: Medication errors were common: 39.4% of parents made an error in measurement of the intended dose, 41.1% made an error in the prescribed dose. Furthermore, 16.7% used a nonstandard instrument. Compared with parents who used milliliter-only, parents who used teaspoon or tablespoon units had twice the odds of making an error with the intended (42.5% vs 27.6%, P = .02; adjusted odds ratio=2.3; 95% confidence interval, 1.2-4.4) and prescribed (45.1% vs 31.4%, P = .04; adjusted odds ratio= 1.9; 95% confidence interval, 1.03-3.5) dose; associations greater for parents with low health literacy and non-English speakers. Nonstandard instrument use partially mediated teaspoon and tablespoon-associated measurement errors. CONCLUSIONS: Findings support a milliliter-only standard to reduce medication errors.
引用
收藏
页码:E354 / E361
页数:8
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