Tuesday, April 8, 2008

Hospitals a Dangerous Place for Children

Here is something to think about if your child is put in the hospital. A study released this week places the risks of children being exposed to medication errors while hospitalized at significantly higher levels than previously estimated. As the article below points out, even the alarming findings of this research are likely underestimated. It is clear we cannot depend on voluntary reporting by health care workers and institutions to get a clear picture of unsafe conditions in our hospitals.

If hospitalization for your child is absolutely necessary, be very watchful and proactive about the care he/she receives. Many children in the study experienced multiple medication errors in the same hospital stay! This can easily lead to a potentially life threatening situation. Always question health care providers about all medication and procedures being used to treat your child. Make sure that you, your spouse, or a trusted family member is with the child at all times. If we as parents do not speak up, often times all of the options and reasoning behind the medication and procedures are not offered. You have the right and responsibility to be privy to all pertinent information regarding the health care of your children.

One more thing. Do not ever allow practitioners, nurses, or hospital aides touch your child unless you have witnessed that they have freshly washed hands or they have put on a new pair of protective gloves. This goes not only for hospital stays but also for doctors office visits. Do not be afraid to speak up, as this is all about preventing the spread of illness and disease.


Drug errors hurt 1 in 15 hospitalized kids
New tool detects far more medication mix-ups, overdoses and bad reactions
The Associated Press
updated 7:41 a.m. CT, Mon., April. 7, 2008

CHICAGO - Medicine mix-ups, accidental overdoses and bad drug reactions harm roughly one out of 15 hospitalized children, according to the first scientific test of a new detection method.

That number is far higher than earlier estimates and bolsters concerns already heightened by well publicized cases like the accidental drug overdose of actor Dennis Quaid's newborn twins last November.

These data and the Dennis Quaid episode are telling us that these kinds of errors and experiencing harm as a result of your health care is much more common than people believe. It's very concerning, said Dr. Charles Homer of the National Initiative for Children's Healthcare Quality. His group helped develop the detection tool used in the study.

Researchers found a rate of 11 drug-related harmful events for every 100 hospitalized children. That compares with an earlier estimate of two per 100 hospitalized children, based on traditional detection methods. The rate reflects the fact that some children experienced more than one drug treatment mistake.

The new estimate translates to 7.3 percent of hospitalized children, or about 540,000 kids each year, a calculation based on government data.

Simply relying on hospital staffers to report such problems had found less than 4 percent of the problems detected in the new study.

Triggers reveal drug mistakes

The new monitoring method developed for the study is a list of 15 triggers on young patients' charts that suggest possible drug-related harm. It includes use of specific antidotes for drug overdoses, suspicious side effects and certain lab tests.

By contrast, traditional methods include nonspecific patient chart reviews and voluntary error reporting.

The researchers said their findings highlight the need for aggressive, evidence-based prevention strategies to decrease the substantial risk for medication-related harm to our pediatric inpatient population.

The study is being released Monday in the April issue of the journal Pediatrics.

It involved a review of randomly selected medical charts for 960 children treated at 12 freestanding children's hospitals nationwide in 2002. Triggers mentioned in the charts promoted an in-depth review of the patients' care.

Patient safety experts said the problem is likely even bigger than the study suggests because it involved only a review of selected charts. Also, the study didn't include general community hospitals, where most U.S. children requiring hospitalization are treated.

Study author Dr. Paul Sharek said evidence is needed to show whether a big push to prevent medical errors in recent years has put a dent in the problem since 2002, when the data were gathered.

Homer, of the children's healthcare initiative, said some hospitals have started using trigger methods similar to those in the study. But he added, we still have a long way to go.

Painkillers cause overdoses, reactions

Among triggers on the list was use of the drug naloxone, an antidote for an overdose of morphine and related painkillers. Symptoms include breathing difficulty and very low blood pressure.

More than half the problems the study found were related to these powerful painkillers, including overdoses and allergic reactions.

While 22 percent of the problems were considered preventable, most were relatively mild. None were fatal or caused permanent damage, but some did have the potential to cause some significant harm, said Sharek, who is medical director of quality at Stanford University's Lucile Packard Children's Hospital.

Other triggers included use of vitamin K, an antidote for an overdose of the blood thinner Coumadin; use of a blood test that detects insulin overdoses; and a lab test that identifies blood-clotting problems that can come from an overdose of the blood thinner heparin and other drugs.

Quaid's twins got accidental life-threatening heparin overdoses in a Los Angeles hospital shortly after they were born last November. The actor and his wife, Kimberly, have since formed a foundation to prevent medical errors. The babies recovered and Quaid said in an interview with The Associated Press on Saturday that they appear to be normal kids, very happy and healthy.

Monitor caregivers, Quaid urges

Quaid praised the new study for raising awareness about an under-recognized problem, and said he'd never envisioned having to play the role of public health advocate before the harrowing experience. He called it the most frightening time of his life.

Quaid's advice to parents of hospitalized children?

Every time a caregiver comes into the room, I would check and ask the nurse what they're giving them and why, Quaid said.

Allen Vaida of the Institute for Safe Medication Practices said trigger methods like those used in the study can help. Still, amore comprehensive approach is needed, he said, to detect the most serious, least common errors like those involving the Quaids.

Voluntary reporting by hospital staffers is still needed, along with methods to detect errors in time to prevent or lessen any harm to patients, Vaida said.

http://www.msnbc.msn.com/id/23982564/


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