Published September 17, 2021 (current as of June 20, 2024)
Today, parents can often visit and stay with their sick, hospitalized child whenever they want. Many parents take advantage of this and remain with their child as much as possible, getting more involved in their child’s care. For an ill child, this can be comforting and provide an important emotional benefit, which might lead to faster healing as well as long-term behavioral benefits.1 For the parents, this can lead to less stress, anxiety, and sadness.1
A few studies have been done to determine whether parents who visit and stay with their hospitalized child can detect or contribute to mistakes or bad outcomes. The findings may be somewhat surprising.
Most studies show that parents have helped detect mistakes that could cause harm to their hospitalized child.2-6 In fact, about one in 10 parents have spotted a mistake that healthcare providers missed.2 Some mistakes involved procedures or tests. But most mistakes detected by parents involved medicines. Either a medicine was being given too early or too late, too much medicine was being given, the wrong medicine was being given, or the medicine was not given at all.
Some examples of mistakes with medicines detected by a hospitalized child’s parent included the following:2-6
• A mother realized the wrong dose of a medicine used to treat heart failure was prescribed for her child. The error would have resulted in her child getting five times more medicine than needed.
• A mother noticed the wrong weight was listed on her child’s medical records. The weight was used to calculate doses of medicine for her child.
• A father noticed his child’s arm becoming red and swollen around the intravenous (IV) site. These were signs of an infection that was caused by leaving an IV catheter in his child’s arm too long.
Sometimes, parents who stayed with their hospitalized child drew attention to their child’s worsening condition. For example, parents who noticed that their child seemed to have trouble breathing brought it to the attention of healthcare providers, preventing a serious bad outcome.4 Without the parents’ help, the child’s worsening condition might have continued without correction.
One study found that some parents may feel they need to watch over their hospitalized child’s care to prevent mistakes.3 In that study, parents who felt the need to stay with their child were more likely to detect mistakes than parents who did not feel the need to stay with their child. Specifically, they more frequently asked a healthcare provider about the name or dose of a medicine being given to their child, thus detecting an occasional mistake. This study suggests that it is easier for parents to detect safety problems if they spend more time at their child’s bedside, observing and participating in their care.
Few would disagree that the parents’ onsite participation in their hospitalized child’s care is highly desirable for many reasons. However, studies have shown that, occasionally, parents have contributed to mistakes and bad outcomes.2,4 The most common problems involved the accidental disconnection of tubes and drains, errors with medicines, and physical trauma. Some examples include the following:4
• A mother accidentally disconnected her child’s IV tubing while breast feeding her baby.
• A mother accidentally disconnected a chest tube while holding her child.
• A father fell out of a chair with his child on his lap.
• A father gave his sick child an over-the-counter medicine that was not recommended by the doctor since the medicine was for adult use only.
These mistakes, initiated by parents, were discovered by hospital staff within about 15 minutes. Most of these events caused mild to moderate harm, but quick discovery of the problems prevented more serious harm.
Parents are often affected by mistakes or bad outcomes that happen to their child, or even to other children.1,3,4,6 They may become very anxious and fearful for their child’s health during the hospital stay. However, at the same time, most parents feel insecure and confused, which may hinder their participation and involvement in their child’s care. Parents’ cooperation and participation increases when the healthcare team is willing to accept the parents as safety partners and supports parental participation in caring for the child’s basic needs (e.g., feeding, changing clothes).3,6 Once things are explained, parents become more familiar with the expectations and the plan of care for their child. Parents may be an untapped resource for preventing mistakes and bad outcomes.
To be clear, it’s not the parents’ duty alone to guarantee the safety of their hospitalized child—it is also the duty of healthcare providers who are caring for child. But a parent’s desire to watch over their child’s hospital care is a normal response with a potential positive impact.3 The steps listed below can help parents partner effectively with healthcare providers and be a vigilant safety partner to best protect their child from accidental harm.
Parents can participate in the care of their hospitalized child in a way that best protects them from accidental harm by following these suggetsions:
• Educate yourself. Learn about the disease, medical tests, and the treatment plan for your hospitalized child. Also, learn what medicines your child is receiving, the prescribed doses, and when and how they are given. Write down important information. A parent who knows what to expect can help recognize when something is not right.
• Report anything that worries you. Report anything that worries you or does not seem right with your child. Do not be afraid to speak up. Although doctors and nurses are highly trained regarding your child’s medical condition, you know your child better than anyone on the medical team. Your observations are extremely important.
• Ask questions. If you have questions about your child’s care, you need to ask. Also, if you do not understand the answer you get, you need to ask again.
• Be persistent. Keep asking questions or voicing your concerns about your child’s condition or care until you get an answer that you are entirely comfortable with. If you feel no one is really addressing your concerns, ask to speak to the doctor in charge (medical director), nurse in charge (nursing director), and the patient representative.
• Speak up about the care provided to your child. If you believe something is not being done correctly—perhaps a medicine or medicine dose does not seem right—do not be afraid to speak up. Healthcare professionals are human; they could make a mistake.
• Don’t reconnect tubes. Be aware of the tubes or drains attached to your child. If a tube or drain becomes dislodged or disconnected, do not try to reconnect the tube or drain yourself. Parents and visitors who have reconnected dislodged tubes or drains have sometimes attached them to the wrong connector. Sadly, misconnected tubes and drains have occasionally resulted in serious injuries, even death. Call for a nurse to reattach the tube or drain.
• Get rest. Although parents who stay with their child during hospitalization can help detect problems, parents need adequate rest to effectively participate in their child’s care. Adequate rest is also necessary for safety. For example, a child could fall out of the arms of an overtired parent trying to rock the child to sleep. Don’t be afraid to sleep while your child sleeps. You can ask nurses to wake you if they need to provide care to your child.
References
1. Heisel W. When parents were shut out of their children's health care. Center for Health Journalism. USC Annenberg Web site. Published June 30, 2014. Accessed September 9, 2021.
2. Rapaport L. Mom and dad often catch hospital errors doctors missed. Healthcare & Pharma. Reuters Web site. Published February 29, 2016. Accessed September 9, 2021.
3. Cox ED, Hansen K, Rajamanickam VP, et al. Are parents who feel the need to watch over their children’s care better patient safety partners? Hosp Pediatr. 2017;7(12):716-22.
4. Frey B, Ersch J, Bernet V, Baenziger O, Enderli L, Doell C. Involvement of parents in critical incidents in a neonatal-paediatric intensive care unit. Qual Saf Health Care. 2009;18(6):446-9.
5. Khan A, Furtak SL, Melvin P, Rogers JE, Schuster MA, Landrigan CP. Parent-reported errors and adverse events in hospitalized children. JAMA Pediatr. 2016;170(4):e154608.
6. Bsharat S. Parent’s involvement in preventing errors and maintaining the safety of their hospitalized child in pediatric department. Biomed J Sci Tech Res. 2018:2(5);2929-30.
