SAN FRANCISCO – A simple screening tool administered to parents helped identify a number of potentially serious drug reactions in their hospitalized children, Dr. Michael S. Leonard reported at meeting sponsored by the National Initiative for Children's Healthcare Quality.
The symptom-based questionnaire, requiring only yes/no answers, was offered 408 times and was completed 143 times. Of those, investigators judged 57 (40%) to be “suspected” adverse drug events.
On further examination by a clinical assessment team, seven (12%) of those suspicious events turned out to be actual adverse drug reactions, and six of them required treatment. Describing these results as “surprising,” Dr. Leonard of Women and Children's Hospital of Buffalo (N.Y.) said, “This is a far, far higher number than [in] many of the published studies out there.”
There are other methods of determining the true number of adverse drug events, including incident reports, chart reviews, and “trigger tools” developed by the Institute for Healthcare Improvement (www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral
Without an accurate estimate of the baseline level of adverse drug events, it's difficult to determine whether steps taken to reduce those levels are working.
The survey developed at Women and Children's Hospital of Buffalo has versions in English and Spanish. It does not ask parents to draw conclusions about whether their child is having a reaction to a drug. Instead it asks them whether they've noticed any changes in breathing, redness, swelling, rash, pain, or the child's level of activity during the prior 24 hours. A single affirmative answer to any of these questions defines a suspected adverse event to be investigated further.
The survey was administered on four medical-surgical floors during 5 consecutive days. Patients ranged from infants to adolescents who were being followed by general pediatricians or subspecialists.
Dr. Leonard suggested that this tool, or one like it, could be useful in satisfying the Joint Commission's national patient safety goal 13a, which was established in 2007. Goal 13a calls on health care providers to “define and communicate the means for patients and their families to report concerns about safety and encourage them to do so.”
This tool, or one like it, could be useful in satisfying national patient safety goal 13a. DR. LEONARD