Liquid Medicines: Taking the Right Dose
by Linda Matula Schwartz
Each year during Health Education Week, the St. Luke's Hospital and Health Network Patient Education Advisory Subcommittee presents an educational program to promote patient education, knowledge about health literacy and tips for healthcare providers in teaching patients.
Part of our program in October 2000 included a teaching activity on liquid medicine measurement. This was prompted both by the heightened interest in medication errors since the publication of the report by the Institute of Medicine <http://books.nap.edu/catalog/9728.html> and by information in an article by D. J. Madlon-Kay and F. S. Mosch (1).
Our purpose was to educate our health care providers on the best ways to teach patients about liquid medicine dosing. After Health Education Week, a modified version of the program was developed that can be used at health fairs to teach this information directly.
The posters were developed in MSPowerPoint. Our Photography Department enlarged the image and produced the actual posters for each of our network facilities, but we could have had them made through any of the local print shops that offer this service.
In addition to the poster, we used actual hands-on demonstration. Beneath the poster were placed a variety of teaspoons gathered from local thrift shops. The volume of each spoon had been measured. We put a piece of tape on the back of the spoon bowl with the volume written on it. In addition, we had dosing cups, medication syringes, and medicine spoons. The dosing cups and syringes came from our hospital, but they could have been obtained from a local drugstore. Medicine spoons came from the local dollar store.
Participants were invited to step up to the table and select the teaspoon that they thought actually measured 5 ml - the proper measurements that is meant by "teaspoon" when ordering medications. The spoons ranged from 4.5 to 10 ml. Most chose spoons that were much higher than the proper 5 ml dose.
The instructor then explained why using a medicine spoon or dosing syringe was important to correct measurement. Dosing cups were presented and the pitfalls of their use discussed. For example, it was pointed out how hard the lines can be to read. Barriers to correct dosage measurement, such as poor vision, tremors or limited hand movement were discussed. Handouts of the poster were also available for people to take with them.
People really enjoyed this exercise. At our hospital, not surprisingly, the people working in the cafeteria were the best guessers. One young mother pushing a stroller grabbed her husband and pointed at the poster "SEE ! That's what I've been telling you!" It was an altogether rewarding experience to use the material and we hope that others may be able to use them for teaching both health care providers and consumers.
1. Madlon-Kay, D.J. & Mosch, F. S. (2000). Liquid medication dosing errors. Journal of Family Practice 49(8):741-744.
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