Among the most common causes of accidental death and injury in the United States are medical errors, an issue which can affect children at a much higher rate than any other group. According to a 2001 study in the Journal of the American Medical Association, the rates of medication errors and adverse drug events was comparable between children and adults, but the rates of potential adverse drug events was three times higher for children. At even higher risk were infants in neonatal intensive care units. While there are not currently statistics available for medical errors occurring outside of hospitals, studies are currently underway.
It is important that parents be able to help understand and avoid medical errors for their children, and this fact sheet is intended to aid in that goal.
What are Medical Errors?
Medical errors can occur in a number of ways, from a mistake in the execution of a necessary treatment to an error in judgment which leads to an unnecessary operation. In 1999 the Institute of Medicine issued a report that estimated that between 44,000 and 98,000 people die in U.S. hospitals due to medical errors every single year.
Medical errors are not confined to the hospital, and can occur in any of the following areas:
- Urgent care clinics
- Doctor’s private offices
- The patient’s home
- Pharmacies
- Outpatient surgery locations
An error can involve a variety of different aspects of the care process, including any of the following:
- Medications
- Proper diagnoses
- Medical equipment
- Surgical procedures
- Lab reports
The modern healthcare system is extremely complex and involved, which is one of the primary causes of medical errors. Other times, doctors simply fail to communicate effectively with their patients and educate them about the implications of the medical decisions they are asked to make. The Agency for Healthcare Research and Quality (AHRQ) supported a recent study which found strong evidence that doctors do not provide enough information about the procedures and treatments available and recommended to them for the patient to make an informed decision. This sort of lax education leads all too often to patients who choose not to follow the advice of a doctor and neglect to obtain needed treatments.
What Can You Do to Protect Your Children?
1. Above all else, take an active role in your child’s health care.
By being involved in every decision made about the health care of your child, you can help ensure the quality of the care they receive. Extensive research has indicated time and time again that the best health care results in children are achieved with more involved parents, and there are a number of ways to achieve this. The following are several tips on what works best.
2. Take care to provide careful records of all the medications your child is taking to each of the child’s doctors, including over-the-counter medicines and dietary supplements.
In order for you doctor to be able to adequately identify any potential complications or conflicts between medications and understand the full extent of the child’s medication intake, it is advisable to bring in all of your child’s medications and supplements with you on a doctor visit. Referred to as “brown bagging”, this practice is the most straightforward way to keep your records up to date and improve the quality of your child’s health care.
3. Keep your doctor up to date about any allergies or adverse reactions to medications that your child may have.
Never assume something is on the doctor’s chart already, and go out of your way to protect your child from potential complications.
4. Ensure that prescriptions handed to you by the doctor are legible.
Pharmacists frequently have to look at messy scripts, but if you can’t make out whats written on the prescription there’s a good chance the pharmacists won’t be able to either. Taking this precaution can prevent your child from being dispensed an incorrect medication or dosage.
5. Confirm the prescription when picking up medications from the pharmacy by asking “Is this the medicine prescribed by my child’s doctor?”
The vast majority of medication errors, 88 percent according to a study conducted by the Massachusetts College of Pharmacy and Allied Health Sciences, involve the victim using the wrong medication or the wrong dosage.
6. Make sure you understand all of the relevant information about your child’s medications, and ask questions such as the following when your doctor is prescribing the drug and when you pick it up:
- What is the medicine for?
- What is the medicine’s name?
- How often should my child use the medication, and for how long?
- Should my child avoid certain activities of foods while using the medication?
- What is the appropriate dosage for my child?
- Are there likely side effects, and how should I prepare for them?
- Are there any medications or supplements which it is unsafe to combine the medicine with?
- How long should I expect it to take before I see improvement?
7.If there is anything unclear about the directions on the labels of your child’s medication, be sure to ask for clarification.
In some situations it is important to elaborate on instructions. While a medication may bear the instructions “take four doses daily” it is important to understand if this means during waking hours only or on regular six hour intervals.
8. Be sure to seek out an appropriate device to measure liquid medications, and ensure that you understand how to use it.
Using devices like household teaspoons often leads to incorrect dosages of medications for children, and specialized measuring devices can mitigate this problem. Get your doctor’s advice on what sort of device to use and how to properly use it.
9. Obtain a written description of the potential side effects of any medication your child takes.
Having an understanding of the potential issues a child may experience when taking a medication will allow you to react more quickly and effectively in the event of a reaction. Studies have indicated that having a written account of information about a medication significantly improves their ability to effectively recognize problematic side effects and react accordingly. Any time you notice your child suffering from a dangerous side effect, contact your doctor immediately for guidance.
10. If you have a choice in which hospitable your child has a surgical procedure at, try to select a hospital where that procedure is performed regularly.
By securing a location where the staff is well experienced in the procedure to be undertaken, you will be giving your child the best chance possible to have a smooth and uneventful hospital stay. Make sure your child’s identification bracelet is attached immediately upon admittance to the hospital, and that it is not removed until they leave.
11. Be sure to confirm that staff and health care professionals interacting with your child at the hospital are diligent about hand washing.
Hospitals are one of the primary places in which infections can spread, and hand washing goes a long way toward preventing this problem. Studies have shown that hospital workers who are asked whether they have washed their hands wash their hands more frequently and use more soap when doing so.
12.Go over home treatment plans that your doctor has for your child immediately when your child is discharged from the hospital.
Understanding what the limitations you should place on your child’s activities and what their care needs will be following their discharge is an essential part of completing the medical care process. As a rule, doctors believe that patients think they know more than they actually do about care needs at the time of discharge.
13. Prior to any surgical procedure, be sure that you, your primary care doctor, and the surgeon all agree on and are clear about the procedure to be performed.
Wrong-site surgery and other surgical errors can be easily avoided by confirming the details of a procedure prior to its commencement. Taking steps like signing your initials on the location of a surgery is an excellent way to confirm this.
14. Make your questions and concerns heard.
This is your child’s healthcare, and you have the right to voice your concerns and ask questions of anyone involved in the process.
15. Know who is in charge of your child’s immediate care.
For children who are experiencing multiple medical issues and interact with a variety of hospital staff in different departments, knowing who is in charge is very helpful and important.
16. Confirm that the healthcare professionals working with your child have access to all the necessary health information about your child.
Assuming that everyone in the building is 100% up to speed on your child’s health is a mistake, and should always be confirmed.
17. Bring a friend or family member with you when at the hospital as an advocate; someone who will help get things done and can be trusted to speak up for you even if you can’t.
18. Inquire about each test and procedure, and why it is being done.
Knowing exactly what each test is for can not only help protect your child, but it can protect your family from billings for unnecessary treatments.
19. Anytime your child has a test done, be sure to ask when the results will be made available.
If the doctor or lab does not get in touch with you directly with results, call them to inquire.
20. Learn all that you can about your child’s medical condition by asking the doctor, nurse, and any other reliable sources available to you.
It is important that your child’s treatment be based on the most recent medical and scientific research available. Check with the National Guideline Clearinghouse or a website such as http://healthfinder.gov for confirmation.