MEDICATIONS: PEDIATRIC PATIENT SAFETY — WHAT YOU CAN DO AS A PARENT

Parents have asked me, "What is the best thing I can do for the health of my child?" All the things you would suspect are part of my answer — good nutrition, regular medical care, physical activity, love —and when your child needs health care from time-to-time, be involved in your child's care. You have a key role in helping prevent medical errors that could harm your child.

You know your child like no one else. Being an active participant in your child's health care can help ensure your child gets good care, and it can help prevent mistakes. You are one of your child's greatest assets when it comes to medical care.

Here is the advice I give my patients:

· Tell me everything you can. The more information you give about your child's health history, the better care your child's doctor can provide. In decades past, patients often didn't have an easy way to keep their medical information. The information stopped at the doctor's office in a paper chart and felt inaccessible. Today, electronic personal health records are becoming more and more common. They provide a place to store information, such as when your child received his or her last immunizations, and a way to share this information with all physicians involved in your child's care. You can create a free personal health record for your child by going to www.ihealthrecord.org. If you are moving or changing physicians, make sure to get your child's past medical information before you go. After any physician visit or hospitalization, take a moment to update your child's record.

· Ask me about both the benefits and the risks. There are always benefits and risks to any medication or procedure. Make sure you understand both before making medical decisions about your child's care. Keep in mind there also may be risks to not getting a treatment. Ask as many questions as you need to, and express concerns if you have them.

· When it comes medication, make sure to read the instructions. This applies to both prescription and over-the-counter medications. First, if instructions aren't clear, ask for clarification. Oftentimes, prescription labels do not contain all the information you need. For example, if a pill should be taken twice daily, does this mean once every 12 hours or twice within waking hours? Second, make sure to look at the dosing and make sure it is appropriate for your child's weight and age. If you are measuring out a liquid medication, use a measuring device from your pharmacy. The teaspoons and tablespoons from your kitchen drawer often are not accurate.

· If your child has allergies or there has been a reaction to a medication in the past, let me know. This information can be life-saving, so it is worth repeating. Even if you have told your child's doctor in the past, remind him or her before your child is given a new medication or vaccination. In fact, be a touch paranoid and repeat it one more time when you pick up the prescription from the pharmacy.

· If you are using complementary, alternative or over-the-counter medicine as part of your child's care, I need to know about it. I am always taken aback by the statistics about how many people use alternative treatments in their child's care but don't share this information with their child's doctor. (Currently, it is estimated that this situation applies to at least one in two pediatric patients.) Sadly, some patients feel such information will be met with judgment. The truth is, not sharing this information can be dangerous. Certain medications and procedures can interact with complementary and alternative treatments and cause harm. If you do not feel comfortable sharing all health-related information with your child's physician, look for a physician with whom you do feel comfortable. Patient-physician communication is the cornerstone of good health care.

· Ask for written information. A 2003 study published by the Royal Society of Medicine found that up to 80 percent of the time, patients had forgotten what their physician told them by the time they left the doctor's office. This same study found only 50 percent of the patients who did remember what had been said remembered correctly. Ask your doctor for written instructions or take notes to form your own record. Even if you think you know what those instructions say, refer back to them.

· Call about test results if you haven't been contacted. Oftentimes, we assume that no news means good news. In the case of test results, it can mean misplaced paperwork. If lab tests are being run, ask when results should be ready. If you haven't heard back, place a call and inquire.

Medicine is powerful. It can heal, but when mistakes happen, it can harm. Never be afraid to question. In fact, in doing so, you are setting a great example for your child about learning the facts before making decisions.