LEAVING MEDICATION UNSECURED 7
Unsecured medication is harmful to human life but can be extremelydangerous especially to innocent children. The fatalities or healthcomplications attached to unsecured medication cannot be overlookedand there is a growing need to prevent medication errors like leavingmedicine unsecured (Malloch & Porter, 2009). Leaving medicationunsecured mostly happens accidentally and has dire consequences. As aresult, this research will focus on the imperative need for parentswith toddlers to store medications and poisonous products safely. Thechallenge of leaving unsecured drugs at home is larger than carcrashes today. More than 2100 kids engage in behavior such asaccidental abuse of unsecured medication for the first time (Betar,2012). Accidental use of drugs and wrong medication by toddlers is aresult of unsecured drugs lying somewhere in the house.
Unintentional poisonings at home are a major cause of fatal ornonfatal injuries in children aged 0-24months. Reports from studiescarried out in 2003 showed that 49.6% of all poisonings exposurereported in the USA occurred amongst school going children. 3 out of1000annual poisoning incidents in Dutch children aged between one andtwo was as a result of leaving medication unsecured at home. Thisnumber was much higher as compared to children from other age groups.It revealed that one year olds have a six-fold risk of poisoning ascompared to four year olds. According to Bierens et al (2010),poisoning in children aged 1-2 years occurs due to unsafe storage ofmedication. Unintentional poisonings in children aged 1-2 can beprevented through preventive caution and leaving medication securedin the households. Examples of preventive actions include safehandling of medication by adults only,
labeling all medication,
using child resistant packaging
extra attention and supervision of medications in the house
storing all medication in its rightful place
Leaving no medication lying around
Double-checking any medication before ministering to toddlers (McBride, 2007)
Efforts to promote poisoning preventive measures include child safestorage of medications such as placing them above the adult eye leveland locking the cabinet at all times. Past research showed a largevariation in characteristics of parents and guardians who do notstore medication safely from children. To develop effectiveintervention strategies of leaving medication unsecured and improveparental safety behavior, more insight on the underlying psychosocialmechanisms and modifiable mediators are needed.
Safety and health promoting behaviors are influenced by complexinterrelated sets of so-called behavior mediators or determinants.They include cognition and environmental factors. Behavior can bedetermined through using behavioral and protective motivationtheories. This knowledge will be crucial in explaining certainbehavior and going beyond basic unchangeable risk factors such associoeconomic status. To date little knowledge exists on behavioraltheories and unintentional injury while protective motivation theoryexplains interventions of preventive and precautionary behavior.
Protection motivation theory explains the probability of healthprotective behavior or adaptive response in child safe storage asincreased by four beliefs namely
the threat perceived as severe,
adaptive response is perceived (response efficacy)
personal abilities and self-confidence perceived as self efficacy
The probability of adaptive response decreases with perceivedrewards of the maladaptive response. For example, not using safetylocks as the perceived barriers are costs (pros and cons of safebehavior). This model was adopted for the study to assess theinfluence of personal cognitions and safety behavior attitudes.Psychosocial correlates of parental behaviors concerningunintentional poisoning from medications left unsecured among parentsof toddlers between 11-18 months, to determine the most imperativefactors of safe storage of medications. A model based on the PMTtheory and additional social variables was applied (Bierens, 2010).
Ethical considerations for data collection
An informed consent form was give to all participants to sign. Theconsent included information on discretion and confidentiality of thedata collected through questionnaires. No financial incentives weregiven to parents and they were expected to participate willingly. Theinformation given by participants was useful for data collection ofthe research only and would be processed anonymously. Participants ofthis research were informed about the research objectives as homesafety issues of medications before the onset of the research. Theparents had received pre-survey letters from health care providersinforming them about the research. The recruitment of participantswas done amongst parents of children aged 11-18 months. They werepart of the sample of six preventive healthcare providers inNetherlands, both rural and urban, invited to healthcare centers tofill mailed questionnaires.
Data collection methods included questionnaires and PMT constructs.The questionnaires were 160 questions addressing safe storagebehavior of medication from children. Standard socio-demographicvariables and potential correlates of safe storage behavior wasmeasured in PMT constructs. They were developed as pilot tests weredone among 25 parents, then refined based on interviews. Safetybehavior was measured through asking whether respondents storedvarious products on the floor, table, drawer without locking orsafety catches. Potential correlates of safety behavior were mainlybased on protection motivation theory to assess the influence ofpersonal cognitions and parental safety attitude behavior. PMTconstructs measured perceived vulnerability by asking respondentsabout their perception of the child accidentally swallowing medicine(-2=low risk =2=high risk0. Perceived severity was measured with oneitem (-2=not serious =2=very serious) while response efficacy askedabout for thoughts on storing products out of reach of children aspreventive in possible accidents (-2=not too helpful +2=veryhelpful). All assessments on PMT and psychosocial constructs weremeasured on bipolar five point scales.
The study showed a strong association of unintentional poisoningswith safe storage of the medications. Through perceivedvulnerability, perceived disadvantages of safety behavior,self-efficacy and descriptive norm associations with unsecuredmedication was evident. It can be concluded that through this study,the PMT model is applicable in predicting safety of storingmedication. The associations with psychosocial correlates resultsrevealed that safe storage of medications were reported by 74.4% and60.5% of the respondents. Differences between safe and unsafe storageresults revealed that respondents who stored the medications in achild safe manner had a significantly lower perceived vulnerability,advantages of safe behavior and more positive social influencesasserts Beirens (2010).
An evaluation on the information of this specific study
Information on leaving medication insecure and its consequences likeunintentional poisonings amongst toddlers has not been intensive.Though some scholars have carried out medical researches on safety ofmedicine and safety precautions, research on medication safety in thehouseholds is not thorough. This research specifically hadlimitations that need to be addressed. To start with, the studyrelied on self-report of medication and by parents andmisclassification may have occurred. Parents may have for example,given socially desirable answers like overstating safe storage andsupervision of children when products were stored unsafely. Moreover,they may also have been aware of unsecured medications at home butstill left it unsafely. Such parents perceived their children as morevulnerable to possible unintentional poisoning than parents who storemedication safely.
The research was only able to assess storage practices of parentsrelated to medications and no information on child supervision. Thereis a need for more research on leaving medication unsecured and itseffects on other age groups like teenagers, adults or the elderly.According to Betar (2012), the availability of unsecured drugs athome accounts for 90% of all teenage drug abuse. Further research onleaving medication unsecured will help gather data on the impact ofunsafe medications at home can cause. Leaving medications unsecuredin other facilities like schools and hospitals are other areas ofstudy that can significantly improve research in the medical field.
Summary of conclusions
At home, accidental use of unsecured drugs is on the rise. Kids andinfants are vulnerable and may take medication that is leftcarelessly unsecured. Parents need to practice safety measures at allcosts to protect children and make households safe especially fortoddlers. Preventive measures like storage of medications in lockedcabinets are a crucial step. According to Parran (2001), strategiesto promote safe medication practice include labeling all drugs andkeeping them out of reach of children. Improving medication safety isnot only a requirement but also a safety precaution that we all needto take.
Betar, T. (2012). Prescription drug abuse tragedies impact many asepidemic continues, Desert News, fromhttp://www.deseretnews.com/article/865560775/Prescription-drug-abuse- tragedies-impact-many-as-epidemic-continues.html?pg=all
Bierens, T. Beecke, E, Brug, J. Hertog, P. and Raat, H.(2010).“Research article Why do parents with toddlers store poisonousproducts safely?” International journal of pediatrics,Hindawi publishing coorp. Vol.2010. 8pp.
Malloch, K. & Porter, T.(2009). The handbook on storing andsecuring medications, 2nd ed. American journal ofhealth system pharmacy, 66(21), 1957-58
McBride, K. & Maralyn, F. (2007). “A secondary care nursingperspective on medication administration safety,” Journal ofadvanced nursing, 6091), 58-66 doi:10,111/j1365- 2648.2007.04378
Parran, L. (2001). Shared stories light the way to safe medicationpractices, ONS News,16(7),1 From http://eds.b.ebscohost.com.library.gcu.edu:2048/eds/pdfviewer/pdfviewer?sid=df5b041c- [email protected]&vid=1&hid=113