IS IT A SURPRISE? SHOCKING SUB-OPTIMAL MEDICATION SAFETY IN CHILDREN WITH MEDICAL COMPLEXITY
Notice bibliographique
Résumé
Abstract BACKGROUND There are increasing numbers of children with medical complexity (CMC) worldwide. CMC make multiple transitions between healthcare settings and providers; frequently receiving multiple medications. While the risk of medication error in children is recognized, data on CMC, perhaps one of the most vulnerable groups, is lacking. OBJECTIVES To explore parental knowledge, perceptions and behaviours around medication safety and to identify and describe recalled medication errors in order to guide future efforts in quality and safety. DESIGN/METHODS Study participants: Parents of CMC followed in a university hospital based specialized clinic. Study design: Cross-sectional prospective survey, administered by face-to-face interview. Study methods: Because no pre-existing suitable validated survey tool was identified, a 35-item bilingual survey was developed using quantitative and qualitative methods. Testing for face and construct validity was conducted. Consecutive parents of CMC presenting to a designated clinic were approached for study participation. Following informed consent, parents were interviewed for 12–15 minutes with responses entered into a web-based secure database with integrated statistical analysis for data interpretation. Additional diagnostic, verification and healthcare utilization data were collected from the medical chart. RESULTS Complete data was collected for 51 CMC; 77% of respondents were mothers; 3 parents declined to participate. Children, 35% female, ranged in age between 6 months and 17 years. Polypharmacy was common; 77% of CMC had 3 or more medications, 53% had five or more daily medications. Only 37% of parents reported having a complete list of their child’s medications; less than quarter of those administering liquid medications were able to report the actual dose/concentration. Almost two-thirds of parents were worried that their child might have a medication error in the future with 45% recalling at least one medication error in the past. Of these parents, 76% reported that the error occurred during inpatient hospital stay, most commonly due to a dosage error. The reported impact on the child due to the error included life-threatening situations. CONCLUSION Medication error in CMC is perceived and reported as a significant risk by parents. Nonetheless, only a minority were able to show a list of their child’s medications. The rate of reported errors suggests that existing prevention practices remain suboptimal. Further study in other care settings is warranted to confirm these findings and to determine which strategies may be most effective in reducing the risk of medication error in CMC.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».