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Medical Mistakes & Children: How Can You
Prevent Them?
A couple of years ago my child had to have surgery on her hand. It was the first time for surgery, and I am thankful that there were no medical errors made. But when I look back on the experience, I can think of many things that I might have done differently (location of operation, care of hand after surgery, problems arising from surgery, etc.). If your child ever needs medical attention, surgery, or medication... be sure to do your research. To ensure that your child has good medical care, it's best to be thoroughly confident of your doctor and his/her practice. If any problems develop with your child's medical care, be sure to follow up on them...even if your doctor feels differently than you do. In that case, you should think about getting another opinion.
Your child’s health and safety are not only important to you, but to their doctors, nurses, and other caregivers. You can make a difference in your child’s care by asking the right questions and being actively involved. Below are some helpful tips from The Joint Commission:
What can you do to prepare for your child’s visit to the doctor’s office or hospital?
It’s helpful to write down the following information:
- Your child’s medical history Include vaccinations, allergies, current health problems, and the dates of any surgeries and hospital visits.
- A list of your child’s medicines Include prescription and over-the-counter medicines, vitamins, and herbs. Include the amounts your child takes.
- Questions you have about your child’s health Share this information with your child’s doctor and other caregivers.
What should you ask the doctor?
Find out about all the tests and treatments for your child’s illness or injury. Ask how a treatment will help your child. Understand that more tests or treatments
are not always better for your child.
What if you do not understand what the doctor is saying?
Tell the doctor you do not understand. Ask more questions. By asking questions you are helping the doctor understand what you need. Tell the doctor if you
need someone who speaks your language.
How can you help prevent your child from getting an infection?
Remind caregivers to wash or clean their hands before touching your child. Handwashing helps prevent infection. Remind caregivers to wear clean gloves when they do tasks such as taking blood, touching wounds or examining your child’s private parts.
Taking Medicine Safely What can you do to make sure it is safe for your child to take a new medicine?
Tell the doctor or nurse your child’s current weight or ask them to weigh your child (in kilograms). Medicines for children are based on weight. Ask
the following questions:
- Why does your child need a new medicine? How will it help?
- What are the names of the medicine?
- Is there written information about the medicine?
- What does the medicine look like? Is it a liquid or a pill? What color is the medicine?
- What are the instructions for taking the medicine? Repeat the instructions back to the caregiver.
- What are the side effects?
Remind the doctor or caregiver about your child’s allergies and reactions to any medicines in the past. Tell the doctor or caregiver if you do not understand
any information about the medicine. When you get the medicine, check the label for your child’s name and the correct medicine name and strength.
Can you cut or crush pills or put them in food if your child has trouble swallowing them?
Ask the doctor or pharmacist. As an example, timerelease medicines should not be cut or crushed. Ask if the medicine comes in a liquid or can be given
another way.
What should you do if your child has accidentally taken a medicine or taken too much medicine?
Immediately call your local poison control center or your doctor. Keep these phone numbers handy.
Having a medical or laboratory test What are medical and laboratory tests?
Medical tests include X-rays, MRIs, and CT scans. Lab tests include blood tests and urine samples.
What should you ask about medical and lab tests?
Ask why your child needs a test. Find out which test will be done and what your child should be prepared for during the test. Find out if you can be with your child during the test.
Are there any risks with medical or lab tests?
X-rays and CT scans use radiation. Some patients have received too much radiation. MRIs use strong magnets. Metal objects accidentally pulled into the MRI machine have injured some patients. Ask staff what has been done to make sure your child is safe during the test.
What should you do if your child is having a blood test or other lab test?
Ask to see the label on the container that your child’s sample is put into. The label should have your child’s name and birth date or another piece of information. See that the container is immediately sealed.
What should you do if your child is having an X-ray, MRI or CT scan?
Ask if your child will be given a contrast agent. This is a liquid that makes organs and blood vessels easy to see on X-rays and other tests. Tell staff if your child has had problems with contrast agents before. Immediately tell staff if your child begins to itch or have trouble breathing after getting a contrast agent.
Going to the hospital What is one of the first things you should do to help prevent errors in the hospital?
Check your child’s identification band. Make sure the information on the band is correct. Make sure caregivers check the band and ask your child’s name before giving any medicine, test or treatment. Caregivers should also ask for your child’s birth date or another piece of information.
Can you stay with your child overnight at the hospital?
Check with the hospital. Most hospitals will let a parent stay overnight. It is important that you or someone you trust be with your child whenever possible to be their advocate.
Your child needs to get an IV. What is this?
An IV is an intravenous medicine that goes into the vein. Ask regularly when the IV can be removed. The area where it is placed can become infected.
Here are some tips to help you while your child is in the hospital:
- Write down information. As an example, write down medicine names and amounts.
- Immediately tell caregivers if your child is in pain. They should check your child regularly for pain.
- Your child may be moved to another floor or department. Check that your child gets the correct medicines and treatments after the move. Talk to
caregivers if you think there is any confusion.
- Ask visitors who are ill to call instead or come back when they are well.Your child can easily catch illnesses.
- All staff should wear an identification badge. Ask to see a badge if you can’t see it.
Having a safe operation What can you do to help keep your child safe before going to the hospital?
Ask that any sedatives (sleep medicines) be given at the hospital and not at home before coming to the hospital. Talk to the surgeon and others who will operate on your child. Ask how much experience they have performing the operation. It is important that you are confident in the ability of the people who will operate on your child.
What can you do to help keep your child safe before the operation?
Talk to the surgeon about the part of your child’s body that will be operated on. Ask the surgeon to mark the part to be operated on while you are in the room. This will make sure it is the correct part. Make sure the surgeon marks only the correct part and nowhere else. Ask if you can stay with your child until the sedatives (sleep medicines) begin working and your child falls asleep.
What can you do to help keep your child safe after the operation?
Ask if pediatric specialists will be caring for your child in the recovery area.
What can you do to make sure your child is safe after leaving the hospital?
Ask about the care your child will need at home. Get written instructions. Get the names and phone numbers of people to call if you have questions or in case of an emergency.
20 Tips to Help Prevent Medical Errors in Children, from The Agency for Healthcare Research & Quality
1. The single most important way you can help to prevent errors is to be an active member of your child's health care team. That means taking part in every decision about your child's health care. Research shows that parents who are more involved with their child's care tend to get better results. Some specific tips, based on the latest scientific evidence about what works best, follow.
Medicines:
2. Make sure that all of your child's doctors know about everything your child is taking and his or her weight. This includes prescription and over-the-counter medicines, and dietary supplements such as vitamins and herbs.
At least once a year, bring all of your child's medicines and supplements with you to the doctor. "Brown bagging" your child's medicines can help you and your doctor talk about them and find out if there are any problems. Knowing your child's medication history and weight can help your doctor keep your child's records up to date, which can help your child get better quality care.
3. Make sure your child's doctor knows about any allergies and how your child reacts to medicines. This can help you avoid getting a medicine that can harm your child.
4. When your child's doctor writes you a prescription, make sure you can read it. If you can't read the doctor's handwriting, your pharmacist might not be able to either. Ask the doctor to use block letters to print the name of the drug.
5. When you pick up your child's medicine from the pharmacy, ask: Is this the medicine that my child's doctor prescribed? A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of medicine errors involved the wrong drug or the wrong dose.
6. Ask for information about your child's medicines in terms you can understand—both when the medicines are prescribed and when you receive them at the hospital or pharmacy.
- What is the name of the medicine?
- What is the medicine for?
- Is the dose of this medicine appropriate for my child based on his or her weight?
- How often is my child supposed to take it, and for how long?
- What side effects are likely? What do I do if they occur?
- Is this medicine safe for my child to take with other medicines or dietary supplements?
- What food, drink, or activities should my child avoid while taking this medicine?
- Is the dose of this medicine appropriate for my child based on his or her weight?
- When should I see an improvement?
7. If you have any questions about the directions on your child's medicine labels, ask. Medicine labels can be hard to understand. For example, ask if "four doses daily" means taking a dose every 6 hours around the clock or just during regular waking hours.
8. Ask your pharmacist for the best device to measure your child's liquid medicine. Also, ask questions if you're not sure how to use the device. Research shows that many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked oral syringes, help people to measure the right dose. Being told how to use the devices helps even more.
9. Ask for written information about the side effects your child's medicine could cause. If you know what might happen, you will be better prepared if it does-or, if something unexpected happens instead. That way, you can report the problem right away and get help before it gets worse. A study found that written information about medicines can help people recognize problem side effects. If your child experiences side effects, alert the doctor and pharmacist right away.
Hospital Stays:
10. If you have a choice, choose a hospital at which many children have the procedure or surgery your child needs. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition. Find out how many of the procedures have been performed at the hospital. While your child is in the hospital, make sure he or she is always wearing an identification bracelet.
11. If your child is in the hospital, ask all health care workers who have direct contact with your child whether they have washed their hands. Handwashing is an important way to prevent the spread of infections in hospitals. Yet, it is not done regularly or thoroughly enough. A study found that when patients checked whether health care workers washed their hands, the workers washed their hands more often and used more soap.
12. When your child is being discharged from the hospital, ask his or her doctor to explain the treatment plan you will use at home. This includes learning about your child's medicines and finding out when he or she can get back to regular activities. Research shows that at discharge time, doctors think people understand more than they really do about what they should or should not do when they return home.
Surgery:
13. If your child is having surgery, make sure that you, your child's doctor, and the surgeon all agree and are clear on exactly what will be done. Doing surgery at the wrong site (for example, operating on the left knee instead of the right) is rare—but even once is too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopaedic Surgeons urges its members to sign their initials directly on the site to be operated on before the surgery.
14. Other steps you can take: Speak up if you have questions or concerns. You have a right to question anyone who is involved with your child's care.
15. Make sure that you know who (such as your child's pediatrician) is in charge of his or her care. This is especially important if your child has many health problems or is in a hospital.
16. Make sure that all health professionals involved in your child's care have important health information about him or her. Do not assume that everyone knows everything they need to. Don't be afraid to speak up.
17. Ask a family member or friend to be there with you and to be your advocate. Choose someone who can help get things done and speak up for you if you can't.
18. Ask why each test or procedure is being done. It is a good idea to find out why a test or treatment is needed and how it can help. Your child could be better off without it.
19. If your child has a test, ask when the results will be available. If you don't hear from the doctor or the lab, call to ask about the test results.
20. Learn about your child's condition and treatments by asking the doctor and nurse and by using other reliable sources.
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Related articles on MyParenTime.com:
Medical Mistakes
Strategies to Reduce Medication Errors
Helpful checklist:
Doctor Appointment Tracker Checklist (Quick Calendar View)
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Click here to read other articles by The Joint Commission.
Click here to read other articles by The Agency for Healthcare Research & Quality.
Copyright © My ParenTime's Family Community (opening paragraph); The Joint Commission, the largest health care accrediting body in the United States that promotes quality and safety; and The Agency for Healthcare Research & Quality (20 Tips to Help Prevent Medical Errors in Children).
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