Parental involvement in paediatric patient safety incidents in general practice: a cross-sectional study.

Abstract

Children are a vulnerable patient group at risk of healthcare-associated harms, relying on others to support their healthcare needs. Parents, guardians, and caregivers may play a key role in both the aetiology and detection of unsafe care. To explore how and in what circumstances parents may inadvertently contribute to or help mitigate against paediatric patient safety incidents in general practice. A cross-sectional exploratory descriptive analysis was conducted of paediatric patient safety incidents occurring in general practice, with explicit evidence of parental involvement, between September 2014 and February 2023. GPs coded the included reports' free text using the PatIent SAfety (PISA) classification system to identify the types of incidents, contributing factors, or mitigatory actions, and the resultant harm outcomes. Coded data were described and summarised using frequency tables and cross-tabulations. Of 374 reports included, most reports described mitigatory actions by parents (<i>n</i> = 287, 76.7%). Parents frequently mitigated incidents relating to medications (for example, prescribing), diagnosis and assessment, and administrative processes. Common mitigatory actions included recognising medication issues, chasing appointments, and providing feedback. These actions prevented harm or further harm from occurring in over half of reported incidents (54.4%, <i>n</i> = 156/287). The actions of parents have a direct impact on paediatric safety within general practice. This study identified several positive mitigatory actions taken by parents to keep their children safe. Primary care teams working to improve and design safer systems of care delivery for children in general practice should embrace the opportunity to learn with and from parents.