From the February 2010 issue

A study published earlier this month (Shonna Yin H, Mendelsohn AL, Wolf MS, et al. Parents’ medication administration errors: role of dosing instruments and health literacy. Arch Pediatr Adolesc Med. 2010;164(2):181-186.) assessed parents’ liquid medication administration errors by dosing device type and the influence of parents’ health literacy on dosing accuracy. Parents were observed for dosing accuracy of a 5-mL dose using a set of standardized dosing devices. These dosing devices included a dosing cup with printed markings, a dosing cup with etched markings, a dropper, a dosing spoon, and two oral syringes, one with and the other without a bottle adapter. When using a dosing cup with printed markings 30.5% of the parents were able to accurately measure a dose. Roughly half of parents accurately measured a dose using a cup with etched markings. More than 85% of the parents measured doses accurately with the other devices. Large dosing errors (greater than 40% deviation from the recommended dose) were made by 25.8% of the parents using the cup with printed markings and 23.3% of the parents using the cup with etched markings. Parents were able to use oral syringes and a dropper to accurately measure the dose more than 90% of the time. Also, dosing errors by parents were highly prevalent with cups compared with droppers, spoons, or syringes. The study did find that limited health literacy was associated with making a dosing error. To ensure your patients and their caregivers can accurately measure doses of medications, provide them with an appropriate measuring device and utilize the “teach back” method to assess understanding.