Parents as Partners in Obtaining the Medication History
- Affiliations of the authors: Department of Medicine (SCP, ISK, DAG), and Children's Hospital Informatics Program (SCP, ISK), Children's Hospital Boston, Boston, MA
- Correspondence and reprints: Stephen C. Porter, MD, MPH, MSc, Division of Emergency Medicine, MA-001, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115; e-mail: <stephen.porter{at}childrens.harvard.edu>
- Received 5 October 2004
- Accepted 30 December 2004
Abstract
Objective Patient-centered information management may overcome barriers that impede high-quality, safe care in the emergency department (ED). The utility of parents' report of medication data via a multimedia, touch screen interface, the asthma kiosk, was investigated. Our specific aims were (1) to estimate the validity of parents' electronically entered medication history for asthma and (2) to compare the parents' kiosk entries regarding medications to the documentation of ED physicians and nurses.
Methods We enrolled a cohort of parents to use the asthma kiosk and tested the validity of this communication channel for medication data specific to pediatric asthma. Parents' data provided via the kiosk during the ED encounter and the documentation of ED nurses and physicians were compared with a telephone-based interview with the parent after discharge that reviewed all asthma-specific medications physically present in the home. Treating clinicians in the ED were blinded to the parents' kiosk entries.
Results Sixty-six parents were enrolled and 49 of 66 (74.2%) completed the gold standard interview. When analyzed at the level of individual medications, the validity of parental report was 81% for medication name, 79% for route of delivery, 66% for the form of the medication, and 60% for dose. Parents' report improved on the validity of documentation by physicians across all medication details save for medication name. Parents' report was more valid than nursing documentation at triage for all medication details.
Conclusion Parents can provide an independent source of medication data that improves on current documentation for key variables that impact quality and safety in emergency asthma care.
Footnotes
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Portions of this manuscript were presented in abstract form at the Pediatrics Academic Societies Meeting, May 2004, San Francisco, CA.
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Supported by grant K08 HS11660-02 to Dr. Stephen Porter from the Agency for Healthcare Research and Quality and by a grant from the Charles H. Hood Foundation, Boston, MA.
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The authors thank Dr. Zhaohui Cai and Ms. Sandra Lopez for their worthy efforts in the development and testing of the asthma kiosk.
