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Kumarasinghe M, Weerasinghe MC. Reconstitution of oral antibiotic suspensions for paediatric use in households: a cross-sectional study among caregivers of 3-5-year-old children from a selected district, Sri Lanka. BMC Pediatr 2024; 24:241. [PMID: 38575910 PMCID: PMC10996081 DOI: 10.1186/s12887-024-04725-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Reconstitution of oral pediatric antibiotic suspension by primary caregivers plays an essential role in determining the overall health outcome of the child. Incorrect reconstitution techniques could lead to underdosing, overdosing, or introduction of infection. Underdosing could lead to non-resolving infection and antimicrobial resistance. OBJECTIVES To assess the practice and associated factors on reconstitution of oral pediatric antibiotic suspensions (OPAS) among primary caregivers of 3-5-year-old children in a selected district in Sri Lanka. METHODS A cross-sectional study was carried out among 835 primary caregivers selected using two-stage cluster sampling at field clinics to assess practices for the reconstitution of OPAS. A live demonstration of the reconstitution of the OPAS was assessed by a checklist. Associated factors with caregiver practices on reconstitution were assessed using Chi-square with the statistical significance level set at 0.05. RESULTS A total of 820 respondents were recruited and completed the study (response rate = 98.2%). Overall, 56.0% displayed good performance in the demonstration of reconstitution of oral pediatric antibiotic suspension. Poorest performances were observed in shaking the bottle to loosen the powder (Correct: 53.7%), topping up the bottle with water up to the marked line (Correct: 58.0%), and filling the water below the marked line in the bottle (Correct: 59.0%). Caregivers in urban areas compared to rural and estate regions (45.6% vs. 22.7% and 26.5% respectively) and caregivers aged 35 years or above compared to less than 35 years age group (31.5% vs. 22.5%) performed the reconstitution of OPAS poorly. Parental factors, namely age, gender, level of education, and geographical region (urban/rural/estate) were significantly associated with the performance in reconstituting the oral paediatric antibiotic suspension (p = 0.002, p < 0.001, p < 0.001, and p < 0.001 respectively). Factors related to the child, specifically whether they attend preschool and whether they have an older sibling, were found to have a significant association with the correct execution of the reconstitution of OPAS (p = 0.017, and p = 0.030 respectively). CONCLUSIONS AND RECOMMENDATIONS A significant number of primary caregivers displayed poor practice in key steps during the reconstitution of OPAS, which could have a negative impact on the health of the child. Targeted place-based behavioural change health programs with the use of infographic leaflets/ posters may correct the practices of caregivers.
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Affiliation(s)
- Malith Kumarasinghe
- Epidemiology Unit, Ministry of Health, No 54/A, New Jayaweera Road, Ethul-Kotte, Sri Jayawardhanapura Kotte, Colombo, 10100, Sri Lanka.
| | - Manuj C Weerasinghe
- Epidemiology Unit, Ministry of Health, No 54/A, New Jayaweera Road, Ethul-Kotte, Sri Jayawardhanapura Kotte, Colombo, 10100, Sri Lanka
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Nadeshkumar A, Sathiadas G, Sri Ranganathan S. Administration of oral dosage forms of medicines to children in a resource limited setting. PLoS One 2022; 17:e0276379. [PMID: 36548310 PMCID: PMC9778530 DOI: 10.1371/journal.pone.0276379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There are many paediatric specific challenges such as lack of age-appropriate dosage forms, inability of young children to swallow tablets and capsules and poor acceptability, during administration of oral dosage forms of medications to children. Parents adopt various methods which they consider best to circumvent this problem. The objective of this study was to describe the administration practice by parents when giving oral dosage forms of medications to children. METHODS A descriptive cross-sectional study was conducted to assess the administration practice of 1800 oral dosage forms of medications administered to children under the age of 12 years using validated indicators. A pre-tested interviewer-administered questionnaire given to parents or caregivers was used to collect the necessary data. The data were analysed using descriptive statistics. RESULTS Data from 1800 oral dosage forms was obtained from 663 children. Of the 1287 solid dosage forms, almost one-third were manipulated by parents at the time of giving the medications to children. They were crushed and dissolved in water given to children. In about 17% of instances safety of water was questionable. In 92% of instances, measuring device was found to be inappropriate. CONCLUSION Administration of oral dosage forms of medications to children is far from ideal and hinders successful use of medications in children.
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Affiliation(s)
- Abarna Nadeshkumar
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka,Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka,* E-mail:
| | - Gitanjali Sathiadas
- Department of Paediatrics, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
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AlKaddour NA, Shah RB, Gillani SW, Sharafi NH, Khan AF, Elshafie RM, Rathore HA. A cross-sectional survey among parents to report challenges and barriers in the administration of drugs to children. F1000Res 2022; 11:1431. [PMID: 37065930 PMCID: PMC10090859 DOI: 10.12688/f1000research.123317.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Lack of knowledge among parents can result in inappropriate administration practices. After analyzing different studies among children, there was no data on challenges and barriers in the administration of drugs among children in this region because of the diverse environmental issues and challenges in the UAE. The objective of this study was to determine the reported administration practices of parents and challenges and barriers in the administration of drugs among children in UAE. Methods: A questionnaire-based survey was conducted. A convenience sampling technique was used to collect the data. An online Raosoft® sample size calculator was applied (n = 248). The inclusion criteria were parents who had a child under 10 years of age and gave consent to participate in this study. Children with vision problems, cognitive/physical disabilities, and caregivers other than parents were excluded from this study. Results: The study reported response rate of 73.2%. The mean ± S.D age of the parents in years was 35.5 ± 7.8, and the mean ± S.D of children aged years was 2.60 ± 1.54. The majority of parents (83.9%) completing the survey were mothers and resided in the city (97.2%). When the children did not like taking tablet drugs 41.9% used multiple practices and 26.2% of parents reported treatment failure due to oral drug administration. Around 47.6% of those who were interviewed reported that their children had swallowing problems during the administration of oral medication. A total of 22.2% of parents reported that they gave drugs in doses higher than prescribed by the doctor to treat their children more quickly. Similarly, a total of 64.5% of the parents reported self-medication without consultation from a healthcare provider. Conclusions: The study concluded that there were inappropriate drug administration practices among parents. Parents reported administration of higher doses to treat their children quickly.
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Affiliation(s)
- Nour Aliyan AlKaddour
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Rawa Banoori Shah
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Syed Wasif Gillani
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Niloofar Hadi Sharafi
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Aiman Fatima Khan
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Riham Mohamed Elshafie
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
- Clinical Pharmacy Department, ASUSH, Ain Shams University, Cairo, Egypt
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AlKaddour NA, Shah RB, Gillani SW, Sharafi NH, Khan AF, Elshafie RM, Rathore HA. A cross-sectional survey among parents to report challenges and barriers in the administration of medicines to children in United Arab Emirates. F1000Res 2022; 11:1431. [PMID: 37065930 PMCID: PMC10090859 DOI: 10.12688/f1000research.123317.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/19/2023] Open
Abstract
Background: Lack of knowledge among parents can result in inappropriate administration practices. After analyzing different studies among children, there was no data on challenges and barriers in the administration of medicines among children in this region because of the diverse environmental issues and challenges in the UAE. The objective of this study was to determine the reported administration practices of parents and challenges and barriers in the administration of medicines among children in UAE. Methods: A questionnaire-based survey was conducted. A convenience sampling technique was used to collect the data. An online Raosoft® sample size calculator was applied (n = 248). The inclusion criteria were parents who had a child under 10 years of age and gave consent to participate in this study. Children with vision problems, cognitive/physical disabilities, and caregivers other than parents were excluded from this study. Results: The study reported response rate of 73.2%. The mean ± S.D age of the parents in years was 35.5 ± 7.8, and the mean ± S.D of children aged years was 2.60 ± 1.54. 26.2% of parents reported treatment failure due to oral medicine administration. A total of 22.2% of parents reported that they gave medicines in doses higher than prescribed by the doctor to treat their children more quickly. Similarly, a total of 64.5% of the parents reported self-medication without consultation from a healthcare provider. Conclusions: The study concluded that there were inappropriate medicine administration practices among parents. Parents reported administration of higher doses to treat their children quickly.
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Affiliation(s)
- Nour Aliyan AlKaddour
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Rawa Banoori Shah
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Syed Wasif Gillani
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Niloofar Hadi Sharafi
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Aiman Fatima Khan
- Department of Pharmacy Practice, Gulf Medical University, Ajman, United Arab Emirates
| | - Riham Mohamed Elshafie
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
- Clinical Pharmacy Department, ASUSH, Ain Shams University, Cairo, Egypt
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Tiozzo E, Rosati P, Brancaccio M, Biagioli V, Ricci R, d'Inzeo V, Scarselletta G, Piga S, MSc S, Vanzi V, Dall'Oglio I, Gawronski O, Offidani C, Pulimeno MA, Raponi M. A Cell-Phone Medication Error eHealth App for Managing Safety in Chronically Ill Young Patients at Home: A Prospective Study. Telemed J E Health 2022; 29:584-592. [PMID: 36070555 DOI: 10.1089/tmj.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Whereas ample information describes medication errors (MEs) in children or in mixed pediatric and adult populations discharged with acute or chronic diseases from hospital to community settings, little is known about MEs in children and adolescents with chronic diseases discharged home, a major concern. To promote home medication safety, we trained parents of children discharged with chronic diseases to record ME with a tailored cell-phone eHealth app. Methods: In a 1-year prospective study, we used the app to monitor ME in patients with chronic diseases discharged home from a tertiary hospital in Rome, Italy. Univariate and multivariate analyses detected the ME incidence rate ratio (IRR). Results: Of the 310 parents enrolled, 194 used the app. The 41 MEs involved all drug management phases. The ME IRR was 0.46 errors per child. Children <1 year had the highest ME risk (1.69 vs. 0.35, p = 0.002). Children discharged from the cardiology unit had a statistically higher ME IRR than others (3.66, 95% confidence interval: 1.01-13.23%). Conclusions: The highest ME risk at home involves children with chronic diseases <1 year old. A significant ME IRR at home concerns children with heart diseases of any age. Parents find a tailored eHealth app for monitoring and reporting ME at home easy to use. At discharge, clinical teams need to identify age-related and disease-residual risks to target additional actions for monitoring ME, thus increasing medication safety at home.
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Affiliation(s)
- Emanuela Tiozzo
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paola Rosati
- Clinical Pathways and Epidemiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Matilde Brancaccio
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Critical Care Department, Sant'Andrea Hospital, Rome, Italy
| | - Valentina Biagioli
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Riccardo Ricci
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Victoria d'Inzeo
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gianna Scarselletta
- Cardiology and Cardiac Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Stat MSc
- Clinical Pathways and Epidemiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Valentina Vanzi
- University Department of Pediatrics, and Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Immacolata Dall'Oglio
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Orsola Gawronski
- Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Offidani
- Unit of Legal Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Ausilia Pulimeno
- Center of Excellence for Nursing Scholarship, Nursing Professions Order of Rome (OPI), Rome, Italy
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Manworren RCB. Nurses' management of children's acute postoperative pain: A theory of bureaucratic caring deductive study. J Pediatr Nurs 2022; 64:42-55. [PMID: 35149258 DOI: 10.1016/j.pedn.2022.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Few studies have examined the translation of nurses' knowledge of pain management into clinical practice or how nurses negotiated the bureaucracy of caring to treat patients' acute pain. PURPOSE This study describes factors that influence pediatric nurses' actions in caring for hospitalized children's acute post-surgical pain. METHOD Ray's Theory of Bureaucratic Caring provided the theoretical framework for this mixed methods study of ethnography and human factors engineering. Fourteen nurses were observed throughout their shifts (175.5 h) to elucidate humanistic and bureaucratic influences. FINDINGS Of 105 pain assessments, nurses intervened with pharmacologic (n = 45) and biobehavioral (n = 13) interventions for pediatric patients' post-surgical pain in less than 11 min; and 25 assessments revealed patients did not have pain. Pain was assessed and no intervention was provided to 4 patients who were asleep, 5 patients who refused, 2 patients who had no ordered analgesics and 10 patients who were assessed prior to peak effectiveness of their prior analgesic. Overall pain was well-controlled. Of the 28 themes identified, the interplay of 6 categorized to the social/cultural humanistic, 7 political, and 6 technologic/physiological bureaucratic dimensions most strongly influenced pain care. DISCUSSION To achieve optimal pain care outcomes, nurses' and parents' pain management knowledge was less influential for clinical practice translation than nurses' negotiation of other dimensions of bureaucratic caring.
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Affiliation(s)
- Renee C B Manworren
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 100, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 100, Chicago, IL 60611, USA.
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Daifallah A, Jabr R, Al-Tawil F, Elkourdi M, Salman Z, Koni A, Samara A, Al-Jabi SW, Zyoud SH. An assessment of parents' knowledge and awareness regarding paracetamol use in children: a cross-sectional study from Palestine. BMC Public Health 2021; 21:380. [PMID: 33602192 PMCID: PMC7890973 DOI: 10.1186/s12889-021-10432-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Paracetamol, also known as acetaminophen, is one of the most common antipyretic and analgesic over-the-counter (OTC) medicines administered to children due to its efficacy, safety, and availability in many pharmaceutical forms, including suppositories, syrup, and drops. Parents frequently administer the wrong dose of paracetamol by mistake for their children, as reported by many previous studies. We aimed in this study to assess parents' knowledge, attitudes, and practice regarding paracetamol dosing and toxicity, as well as their awareness regarding paracetamol-containing products. METHODS This was a cross-sectional study that targeted parents of children seeking healthcare services at primary health care centers in the Nablus area in the West Bank, Palestine. We used questionnaire-based interviews with parents for data collection. RESULTS A total of 300 parents were included in the study. Most of the caregivers surveyed were (87%) females (mothers). About half the parents (50.9%) reported previously using paracetamol as an antipyretic in children under the age of six. A quarter (25.4%) preferred the syrup forms, while 33.8% preferred the suppository dosage form. Medical personnel was the primary source of information for half the caregivers (51.2%). The mean knowledge score about paracetamol was 2.1 (SD = 1.4) out of 6, and the median was 2.0 with an interquartile range of 1.0-3.0. Two hundred seventy-four (95.5%) of the participants scored less than 80% and were considered to have insufficient knowledge. Only 50.9% of parents recognized that paracetamol overdose could result in serious harm. CONCLUSIONS We found a serious lack of knowledge regarding paracetamol dosing, administration, and potential toxicity among Palestinian parents. We recommend raising awareness regarding this problem among healthcare providers and authorities and working on plans that aim to provide caregivers with accurate and adequate information on dosing, formulation, side effects, and other aspects of paracetamol use, as well as developing effective educational plans targeting healthcare providers, as well as the public.
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Affiliation(s)
- Aiman Daifallah
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ruba Jabr
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Faraj Al-Tawil
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Moutaz Elkourdi
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ziad Salman
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Amer Koni
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahmad Samara
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samah W. Al-Jabi
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839 Palestine
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