Abstract
Aims This quality improvement project was centred around parent or primary carer administration of medication (PAM) to paediatric inpatients at a specialist children’s hospital in England. Parents providing in-hospital care to their children reduces the emotional trauma to the child and is a good opportunity for education of parents on how to perform certain tasks.1 2 However, parents are still not widely involved in all aspects of their children’s care in hospitals across the UK. The aims of this project were to identify possible facilitators and barriers to parents safely administering medications to their children whilst in hospital.
Method Between January and March 2023, parents and primary carers of inpatients aged less than eighteen years old were invited to complete electronic questionnaires regarding perceived advantages and disadvantages of PAM. Those who were unable to complete the questionnaire due to difficulty reading English or lack of access to electronic devices were excluded, as were those parents or primary carers about whom safeguarding concerns were raised. Results were analysed via descriptive statistics and thematic analysis of written responses.
Results A total of twenty-five survey responses were received. Of these, one patient was not receiving medication. Of the twenty-four parents/primary carers who were surveyed, six were already administering their child’s medications, six were aware that this was possible but chose not to administer medications and twelve were unaware that they were able to administer their child’s medication. Of these twelve, nine respondents indicated they would be willing to proceed with PAM. Respondents reported that nurses were the staff group who raised most awareness, followed by doctors and then by ‘other healthcare staff’.
Several facilitators to PAM were identified in free-text responses to the questionnaire, including belief that PAM would be less distressing for patients, respondents also indicated that administering medications to their child in hospital would increase confidence in medication administration required on discharge. There was also a reported perception that PAM would lead to a reduction in nursing workload and reduced delays in medication administration. In those parents who had already administered medication, most reported that they had had no difficulty in doing so.
Numerous barriers to PAM were also identified. These included concern from respondents about the risk of medication errors due to lack of experience in medication administration. Several respondents also expressed concerns about the difficulty of administering medication.
Conclusions The results indicate a lack of awareness of the parental administration of medication scheme among parents and primary carers. Facilitators to engagement with the PAM scheme were based around perceived benefits, including comfort of children receiving medications, improved efficiency of medication administration and increased confidence of parents and primary carers administering medications correctly following discharge. Barriers to engagement with the PAM scheme which were identified were based around fear of medication errors and difficulty in administering medications.
References
James VL, Wheeler WE. The care by parent unit. Pediatrics 1969;43:488–494. 10.1542/peds.43.4.488.
Williams L, Caldwell N, Collins E. Helping parents/carers to give medicines to children in hospital. Archives of Disease in Childhood 2016;101:e2.
