Optimizing parents' performance in anticonvulsant rescue medication administration

Schumacher, Pia M.; Kaune, Almuth; Merkenschlager, Andreas; Bernhard, Matthias K.; Kieß, Wieland; Neininger, Martina Patrizia; Bertsche, Astrid; Bertsche, Thilo

doi:10.1016/j.yebeh.2018.02.032

Cited by 14 publications

(8 citation statements)

References 17 publications

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“…Indeed, in 18% of the demonstrations, a correct administration procedure was observed, while the administration route was chosen correctly by half of the enrolled parents. Numerous errors, as recently reported in several studies [18][19][20], were recorded in our study. Nevertheless, the willingness to use the device in an actual emergency reported by 60% of parents barely exceeds the self-assessment of correct use.…”

Section: Rectal Devicesupporting

confidence: 84%

How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment

Müller,

Herziger,

Jeschke

et al. 2024

Pharmacy

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Background: to assess the intuitiveness of parents’ administration of pediatric emergency devices (inhalation, rectal, buccal, nasal, and auto-injector). Methods: We invited parents without prior experience to administer the five devices to dummy dolls. We observed whether the parents chose the correct administration route and subsequently performed the correct administration procedures without clinically relevant errors. We interviewed parents for their self-assessment of their own administration performance and willingness to administer devices in actual emergencies. Results: The correct administration route was best for the inhalation device (81/84, 96% of parents) and worst for the intranasal device (25/126, 20%). The correct administration procedures were best for the buccal device (63/98, 64%) and worst for the auto-injector device (0/93, 0%). Their own administration performance was rated to be best by parents for the inhalation device (59/84, 70%) and worst for the auto-injector device (17/93, 18%). The self-assessment of the correct administration overestimated the correct administration procedures for all the devices except the buccal one. Most parents were willing to administer the inhalation device in an emergency (67/94, 79%), while the fewest were willing to administration procedures the auto-injector device (28/93, 30%). Conclusions: Intuitiveness concerning the correct administration route and the subsequent correct administration procedures have to be improved for all the devices examined. The parents mostly overestimated their performance. Willingness to use a device in an actual emergency depended on the device.

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Section: Rectal Devicesupporting

confidence: 84%

How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment

Müller,

Herziger,

Jeschke

et al. 2024

Pharmacy

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“…One approach could be the development of a visual and acoustic step-by-step guidance for hypoglycemic emergencies, as is used with modern defibrillators. Conventional training also has the potential to reduce errors in the administration of emergency medication [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing Parental Competence and Self-Ratings in Management of Pediatric Type 1 Diabetes and Emergency Glucagon Administration—An Exploratory Observational Study

Eisenhofer,

Neininger,

Bertsche

et al. 2023

Children

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Background: Parents of pediatric patients with type I diabetes require competence in hypoglycemia management and skills in glucagon administration to deal with potentially life-threatening severe hypoglycemia. We aimed to compare parents’ subjective self-ratings to an objective expert assessment of competences and skills in dealing with severe hypoglycemia. Methods: We interviewed 140 participants to assess their subjective self-ratings. The objective expert assessments used a standardized clinical case scenario of severe hypoglycemia and a practical demonstration of glucagon administration. Results: The participants self-rated their competence in hypoglycemia management as good (5) or very good (6), and their skills in administering glucagon as acceptable (3) [Scale: very poor (1) to very good (6)]. In the standardized clinical case scenario, 1.4% (2/140) of participants named all relevant steps of severe hypoglycemia management. In the practical demonstration of glucagon administration, 92.9% (130/140) of participants committed at least one drug handling error; 52.1% (73/140) committed at least one drug handling error rated with high clinical risk. Conclusions: We found discrepancies regarding participants’ subjective self-ratings compared to their performance in the respective objective expert assessments. These discrepancies indicate a lack of error awareness and the need for intervention studies to improve competence in hypoglycemia management and glucagon administration.

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“…Those errors also occurred in parents who had already administered anti-seizure rescue medication in their child. The errors were signi cantly and sustainably reduced by a one-time intervention consisting of the supervised administration of the medication to a dummy doll [22]. Thus, at least parents whose child already had experienced a febrile seizure should optimally receive such a training.…”

Section: Discussionmentioning

confidence: 99%

Febrile Seizures: Perceptions and Knowledge of Parents of Affected and Unaffected Children

Rice¹,

Müller²,

Jeschke³

et al. 2021

Preprint

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Febrile seizures (FS) in children are common. Little is known on parents’ perceptions and knowledge of FS. We interviewed parents of children aged 6 months to 6 years affected (FS-group, 65 parents) or unaffected by FS (unaffected group, 54 parents). Of the FS-group, 32% said they knew their child had a FS when the first event occurred. Of the FS-group, 89% described fear when the child had a seizure with a median intensity of 10/10 (Q25/Q75: 9/10). Of the FS-group, 77% said they (will) observe their child more carefully since the first seizure had happened, 63% (will) give antipyretics earlier at a median temperature of 38.2°C (100.8°F). Of the FS-group, 62% had not informed themselves about FS before the first event occurred (unaffected group: 54% had not informed themselves about FS so far). Of the FS-group, 20% would put a solid object in the mouth of a child having a seizure (unaffected group 39%), and 92% would administer an available anti-seizure rescue medication (unaffected group 78%). Of the FS-group, 71% stated children with FS might suffocate (unaffected group 70%). Conclusion: Information about FS and its management should be more widespread to improve parents’ coping and patient safety.

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Optimizing parents' performance in anticonvulsant rescue medication administration

Cited by 14 publications

References 17 publications

How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment

How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment

Assessing Parental Competence and Self-Ratings in Management of Pediatric Type 1 Diabetes and Emergency Glucagon Administration—An Exploratory Observational Study

Febrile Seizures: Perceptions and Knowledge of Parents of Affected and Unaffected Children

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