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Using a computerized kiosk during emergency treatment for children's asthma improves medication information

When a child arrives in the emergency department (ED) needing treatment for asthma, obtaining the child's medication history can be difficult. Distractions from noise and crowding, multiple clinicians providing care to the same patient, the need for rapid decisions, and communication barriers all threaten to erode proper medication information. Parents can be helpful partners in obtaining their child's medication history in this situation, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS11660).

Stephen C. Porter, M.D., M.P.H., M.Sc., and colleagues at Children's Hospital Boston, asked a group of parents to use a kiosk (a multimedia, touch screen interface in the ED) to provide information about their children's asthma and related medications. Researchers compared the parents' kiosk entries regarding their children's medications to the documentation of ED physicians and nurses.

They also conducted a telephone interview with the parents after discharge to compare the kiosk entries with all asthma-related medications present in the home prior to the ED visit.

Researchers then analyzed the validity of the parent, physician, and nurse reports. A report was considered valid if the medication details obtained from the kiosk matched the information obtained from the telephone interview. The validity of parental report was 81 percent for medication name, 79 percent for route of delivery, 66 percent for form of the medication, and 60 percent for dose. The parents' reports improved the validity of documentation by physicians across all medication details, except for the medication name, and was more valid than nursing documentation at triage.

More details are in "Parents as partners in obtaining the medication history," by Dr. Porter, Isaac S. Kohane, M.D., Ph.D., and Donald A. Goldmann, M.D., in the May 2005 Journal of the American Medical Informatics Association 12(3), pp. 299-305.

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