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 Poorly designed medication labels and dosing tools lead to dosing
errors, especially when parents are given large cups for small
doses, the study team writes in Pediatrics, June 27.
“Parents frequently make errors in dosing medications for their
children. We did this study because we wanted to find out how to
redesign medication labels and dosing tools to help parents
understand dosing instructions better,” lead author Dr. Shonna Yin
told Reuters Health in an email.
It is very easy to get confused when dosing liquid medications for a
child, said Yin, a pediatrician at NYU Langone Medical Center in New
York City.
“To help make sure they give the right dose, parents should ask
their doctor or pharmacist which dosing tool is best to use,” she
said.
The best tool depends on the amount of medication the parent needs
to give the child, Yin said. “Using a tool that is too large or too
small makes it more likely that a parent will make a mistake.”
The researchers recruited 491 English- and Spanish-speaking parents
of children age 8 years or younger, and randomly assigned them to
one of four groups, each with a different combination of medication
labels and dosing tools including assorted cups and syringes.
Parents were given a medication label with instructions in text
only, or both text and pictograms, plus dose measuring tools marked
only in milliliters (mL) or in both mL and teaspoons.
Participants were asked to demonstrate how they’d use the labels and
to measure three different dosage amounts using three different
tools.
About 84 percent of parents made at least one error and almost 30
percent made at least one large error such as doubling the correct
dose.
There were fewer errors, however, when labels contained both text
and pictograms and when dosing cups or syringes were close to and at
least as large as the amount of medication needed.
For a 2-mL dose, for example, the fewest errors were seen with the
5-mL syringe and for the 7.5-mL dose, the fewest errors were with
the 10-mL syringe.
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In addition, parents were about 30 percent more likely to make
mistakes when they used tools marked in mL and teaspoons compared to
mL only.
“It is important for parents to use a tool that has markings on it
to help them measure out the right amount. This could be an oral
syringe, a dropper, a dosing spoon, dosing cup, or even a measuring
spoon that is usually used for cooking,” Yin said.
When using any of these tools, parents should carefully check to see
that the number and the units used on the tool match what they are
trying to give, she added.
“Mixing up milliliters and teaspoons can lead to a parent giving 5
times the dose. If there is no dosing tool at home that has markings
on it, I would recommend going to the store to get one or trying to
get one from the doctor or pharmacist,” Yin said.
“The study makes it clear that it’s easy to make mistakes with
liquid medicine and that using the right syringe can help and that
instructions with pictures help as well,” said Dr. Kathleen Walsh,
director of patient safety research at the James M. Anderson Center
for Health Systems Excellence at Cincinnati Children’s Hospital in
Ohio.
“There are certain medicines that people tend to think of as safe
but actually if you make a big dosing error can be very dangerous,
for example, Tylenol or Benadryl are medicines you really want to be
careful to give the right dose,” she said.
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