|
 Roughly one in ten parents spotted mistakes that physicians did not,
according to the study of safety incidents observed on two
pediatrics units at a hospital in Boston.
“Parents may notice different things than healthcare providers do,
and thereby provide complementary information that can only help
make care safer,” said lead study author Dr. Alisa Khan, a
pediatrics researcher at Harvard Medical School and Boston
Children’s Hospital.
“As anyone who has ever been hospitalized knows, hospitals are very
complex places where there are a lot of moving parts, and errors are
bound to happen despite all of our best efforts,” Khan added by
email. “I think we – including parents – can all work together to
keep children safe.”
To assess how frequently parents detect mistakes that doctors didn’t
catch, Khan and colleagues reviewed data on 383 kids hospitalized in
2013 and 2014.
Parents completed written surveys detailing any safety incidents
their children experienced during their hospital stays.
Then, two physician reviewers classified incidents as medical
errors, other quality issues, or situations that weren’t safety
problems.
Overall, 34 parents (8.9 percent) reported 37 safety incidents, the
researchers report in JAMA Pediatrics.
When doctors reviewed these incidents, they found 62 percent, or 23
of the cases, were medical mistakes. Another 24 percent, or 9
situations, involved other quality issues.
The remaining 14 percent, or 5 cases, were neither mistakes nor
quality problems, the physician reviewers concluded.
For the subset of cases that were medical mistakes, the reviewers
found 30 percent of the incidents caused harm and were preventable.
Children with medical errors appeared to have longer hospital stays,
and these kids were more likely than others in the study to have
either metabolic or neuromuscular conditions.
Preventable errors described by parents included delays detecting a
foreign body left behind after a procedure, recognition and
treatment of urinary retention, and receipt of pain medication.
In one case a poorly dressed wound got contaminated with stool,
while in another instance a child got an infection from an unused
intravenous catheter.
Parents identified communication problems as a contributing factor
in a number of errors, including instances when day and night staff
didn’t note a medication change and when written information for one
patient was documented in a different patient’s medical record.
[to top of second column] |
Beyond its small size and the fact that it was conducted at just one
hospital, other limitations of the study include its reliance on
English-speaking parents and its sample of participants who were
predominantly female, well-educated and affluent, the authors note.
Kids of non-English-speaking parents may be particularly vulnerable
to errors, and it’s possible that including these families might
have exposed even higher rates of parent-reported errors, the
researchers point out.
Even so, the findings add to a growing body of evidence suggesting
that clinicians may often be unaware of errors affecting their
patients, said Dr. Daniel Neuspiel, a pediatrics researcher at the
University of North Carolina School of Medicine in Charlotte who
wasn’t involved in the study.
“The specific frequency of such errors may differ in other
populations, but we know they occur in all clinical settings,”
Neuspiel added by email.
While the study is too small to draw broad conclusions on error
rates or safety, it still highlights the value of parents speaking
up when something seems amiss with their child’s care, said Dr.
Irini Kolaitis, a pediatrics researcher at Northwestern Feinberg
School of Medicine in Chicago who wasn’t involved in the study.
“A parent knows their child better than any member of the health
care team does, stands by their bedside and plays an active role in
their child’s health care delivery throughout their hospitalization
and after discharge, and often has a sense when something is not
right,” Kolaitis said by email. “For these reasons, any perceived
error that a parent reports noting in the care of their child must
be taken seriously.”
SOURCE: http://bit.ly/1adWrco JAMA Pediatrics, online February 29,
2016.
[© 2016 Thomson Reuters. All rights
reserved.] Copyright 2016 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
