Parents are often given open visiting hours to be with their hospitalized child. Many parents take advantage of this option and remain with their child as much as possible. For an ill child, this can be comforting and provide an important emotional benefit, which at times might help them get better faster. In fact, a study by Swiss researcher Bernhard Frey and colleagues, suggests that parents who stay with their hospitalized child can help detect potential adverse events, such as medication errors.
In one case, a mother realized her child had been prescribed the wrong dose of a heart failure medicine. The error would have given her child five times more medicine than needed. In another case, a mother noticed that the wrong weight was listed on her child’s medical records. Since the weight was used to calculate doses of medicine, it could have led to an overdose had she not caught it. All of these events were detected by parents only after visiting hours were no longer restricted to just a few hours a day. This suggests that it is easier for parents to detect safety problems if they spend more hours at their child’s bedside, observing and participating in their care.
However, the same study also showed that parents can sometimes cause the harmful event. The most common problems to which parents contributed involved the misconnection of tubes and drains, errors with medicines, and physical trauma. One mother who was breast feeding her baby accidentally disconnected intravenous tubing. Another mother accidentally disconnected a chest tube while holding the child. In another case, a father fells while his child was on his lap. Most of the disconnected tubes and drains happened in very young children.
These errors by parents were discovered by hospital staff within an average of 15 minutes. Most of these events caused moderate harm. However, quick discovery of the problems averted serious harm.
Even parents can be affected by events that happen to their child or even to other children. The most common types of problems affecting parents involved miscommunication and feeding mix-ups. Examples include a mother who required blood tests to check for viruses because her breast milk was fed to another child and another parent who found out her child’s diagnosis in the hospital cafeteria. Failures such as these surely must increase parental stress during a child’s hospitalization.
It’s not the parents’ duty alone to guarantee the safety of the child but the healthcare providers who are providing care. Still, here’s some help for parents so they can partner effectively with healthcare providers to protect kids from accidental harm.
First, educate yourself. Learn about your hospitalized child’s disease, medical tests, and the treatment plan. Also learn what medicines your child is receiving, the prescribed doses, and when and how they are given. Write down important information. A parent who knows what to expect can help recognize when something is not right.
Report anything that worries you or does not seem right with your child. And don’t be afraid to speak up. Although doctors and nurses are highly trained regarding your child’s medical condition, you know your child better than anyone on the medical team, so your observations are extremely important. If you have questions about your child’s care, you need to ask. If you do not understand the answer you get, you need to ask again. Be persistent. Keep asking questions or voicing your concerns about your child’s condition or care until you get an answer that you are entirely comfortable with. If you feel no one is really addressing your concerns, ask to speak to the doctor in charge (medical director), nurse in charge (nursing director), and the patient representative.
Be aware of the tubes or drains attached to your child. If a tube or drain becomes dislodged or misconnected, do not try to reconnect the tube or drain yourself. Call for a nurse to reattach it. Helpful parents and visitors who have reconnected dislodged tubes or drains have sometimes attached them to the wrong connector. Sadly, misconnected tubes and drains have occasionally resulted in serious injuries, even death. We’ve also heard of some cases where a parent has turned off a sounding alarm or even adjusted the flow rate of an IV. The potential for problems seems obvious.
Get some rest. Although parents who stay with their child during hospitalization can help detect problems, parents need adequate rest to effectively participate in their child’s care. Adequate rest is also necessary for safety. For example, a child could fall out of the arms of an overtired parent trying to rock the child to sleep. Don’t be afraid to sleep while your child sleeps. You can ask nurses to wake you if they need to provide care to your child.
Speak up about the care provided to your child. If you believe something is not being done correctly—perhaps a medicine or medicine dose does not seem right—do not be afraid to speak up. Healthcare professionals are human; they could make a mistake.
For more on ISMP’s consumer website, go www.consumermedsafety.org.