Harumi ARAI received a doctoral degree in health and welfare science from the graduate school of Takasaki University of Health and Welfare. She is a professor in psychiatric nursing and has been conducting field research for over 10 years on palliative care provided and needed for long-stay schizophrenic patients with cancer at psychiatric hospitals.
Western countries have been actively promoting community-based healthcare and welfare for mentally-disabled people. For example, Franco Basaglia (1924-1980), the father of Italian mental healthcare, established a treatment support system for mentally-disabled people, realized hospitalization in open wards, and started home-visit service using cars in 1977, based on the concept of human-rights protection, which triggered the mental healthcare reform in 1978 leading to the provision of new wards (with 15 beds or fewer) for psychiatric inpatients and cooperation with community service, which increased the number of beds per 1,000 people to 0.1. At the end of 1998, Italy declared a complete closure of mental hospitals. The psychiatric healthcare system in Western countries allows people with mental disorders to use community service and shorten hospital stays, thereby supporting them to return to community life. More and more psychiatric wards have been provided at general hospitals. In the United States, Sweden, Norway, the Netherlands, Iceland, Hungary, Czech Republic, Slovakia, etc., beds in psychiatric wards account for 40% or higher of the total number of beds. In countries with a large number of beds for psychiatric patients, there are many nursing homes in communities where elderly patients are living after hospitalization. Although it is not realistic to abolish psychiatric hospitals in Japan, there are still many things to be learned from Western countries, such as the awareness of protection of human rights of mentally-disabled patients and cooperation between mental healthcare providers and communities.
Mi-Ae You is a professor from college of nursing, Ajou University and teaching student about pediatric nursing. She has published research papers in international journals and has been serving as a reviewer. One of her interest areas of research is safe administration of medication. She is currently conducting the project granted from government entitled development and evaluation of mobile web based program about safe medication administration for Kids’ parent.
Statement of the Problem: Most medications for children are produced in liquid form. To prevent dosing errors, parents must be able to understand medicine labels and measure the correct dosage amounts. This study aimed to examine different types of pediatric over-the-counter (OTC) medication in the liquid form, the measuring tools, dosing labels, and the measurement accuracy of OTC medications purchased at pharmacies. Methodology: We purchased OTC medications at pharmacies near one university hospital and four local pediatric clinics in January 2017. The OTC medications were analyzed by type, units used on medication bottle label, marked dosage, and enclosed measuring tools. To examine the accuracy of measuring cups, two examiners measured nine different medicines in the liquid form using the enclosed dosing cups and repeated the measurement using syringes. Conclusion & Significance: A total of 27 OTC oral liquid medications in eight therapeutic categories from 13 pharmaceutical companies were analyzed. The criteria of medication amount on label were age-based dosing and/or weight-based dosing. The dosing tools comprised: dosing cup, dropper, measuring spoon, and oral syringe. Errors in measurement were identified. Overdose or underdose was measured with enclosed dosing cups of OTC medications. The mean of the measurement error was 7.2% in two examinations: 6.7% (0.2–2.0 mL) and 8.7% (0–1.8 mL), individually. Pediatric OTC medicine design needs to be improved, existing safety labels should be revised, and standard dosing devices should be developed to improve parental comprehension and enhance child safety.