Clear clinical instructions needed when children are discharged from hospital

Posted: 25/07/2017

New research reported in the journal Pediatrics, based on a study in the United States, suggests there is a lack of understanding among parents about how to care for children after they have been discharged from hospital. Common problems include how and when to administer medicines at home and what follow-up appointments are needed.

Worryingly, one of the most frequent issues was that parents often gave children too much medication, with over a third of those studied having been given a dose at least 20% higher than prescribed because their parents did not know the correct dose or frequency. Liquid medicines were particularly prone to overdoses.

Nearly two-thirds of parents also failed to appreciate the importance of follow-up appointments.

Guidance on measuring and administering medicines might seem straightforward, but this study suggests clinicians cannot take for granted what parents might understand, particularly where there are socio-economic or language and communication barriers. Fixing follow-up appointments at an early stage, ideally before discharge, is also a key suggestion to improve attendance.

While there are demographic factors and differences between the healthcare systems in the US and the UK, this study highlights the importance of parents being fully conversant with what treatment is being recommended for their children and how to provide this. All clinicians need to be satisfied that parents understand the treatment they are advised to give their child after discharge; how to deliver that care; and importantly, what signs and symptoms to look out for to prompt them to re-attend should further clinical input be needed. Incorrect dosing of medicines and failing to attend follow up appointments risk complications not being identified promptly, or deterioration not being acted on. The result can be devastating for the child and is an unnecessary drain on health resources.

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