Multifaceted intervention reduces liquid medication dosing errors in kids

11 Dec 2020
Multifaceted intervention reduces liquid medication dosing errors in kids

A multifaceted intervention that consists of a simplified dosing handout, a teaching session, teach-back, and provision of a standardized dosing device facilitates safe dosing of liquid acetaminophen and ibuprofen by parents or guardians of children discharged from the emergency department (ED), according to a study.

The study enrolled 149 children aged 90 days to 11.9 years admitted to the ED and their families, among whom 97 were contacted at first follow-up and 35 were included in the trial. They were randomized to undergo standard care (control) or a teaching intervention that combined lay language, simplified handouts, provision of an unmarked dosing syringe, and teach-back to confirm correct dosing.

After ED discharge of the children, parents or guardians were called at 48–72 hours and 5–7 days to assess understanding of correct dosing. More participants in the intervention than in the control group were able to report safe dosing for their child at the time of the first follow-up call, with a difference of 26 percent (71 percent vs 45 percent).

Compared with standard care, the intervention yielded a 58-percent increase in safe dosing reports (relative risk, 1.58, 95 percent confidence interval [CI], 1.12–2.24). This increase remained significant despite adjustment for health literacy and language (adjusted relative risk, 1.50, 95 percent CI, 1.06–2.13).

The findings suggest that a brief intervention at the time of ED discharge can improve parents’ and guardians’ knowledge of safe dosing of liquid medications for their children.

Ann Emerg Med 2020;76:637-645