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Leaving Medication Unsecured
Susan Money
HLT 317V
12/13/2014
Ms. Lemke

Introduction Unsecured medication is harmful to human life but can be extremely dangerous especially to innocent children. The fatalities or health complications attached to unsecured medication cannot be overlooked and there is a growing need to prevent medication errors like leaving medicine unsecured (Malloch & Porter, 2009). Leaving medication unsecured mostly happens accidentally and has dire consequences. As a result, this research will focus on the imperative need for parents with toddlers to store medications and poisonous products safely. The challenge of leaving unsecured drugs at home is larger than car crashes today. More than 2100 kids engage in behavior such as accidental abuse of unsecured medication for the first time (Betar, 2012). Accidental use of drugs and wrong medication by toddlers is a result of unsecured drugs lying somewhere in the house.
Literature review Unintentional poisonings at home are a major cause of fatal or nonfatal injuries in children aged 0-24months. Reports from studies carried out in 2003 showed that 49.6% of all poisonings exposure reported in the USA occurred amongst school going children. 3 out of 1000annual poisoning incidents in Dutch children aged between one and two was as a result of leaving medication unsecured at home. This number was much higher as compared to children from other age groups. In the study, it has come across that one year olds have a six-fold risk of poisoning as compared to four year olds. According to Bierens et al (2010), children poisoned aged 1-2 years is because of unsafe storage of medication. Unintentional poisonings in children aged 1-2 can be prevented through preventive caution and leaving medication secured in the households. Examples of preventive actions include safe handling of medication by adults only, ❖ labeling all medication, ❖ using child resistant packaging ❖ extra attention and supervision of medications in the house ❖ storing all medication in its rightful place ❖ Leaving no medication lying around ❖ Double-checking any medication before ministering to toddlers (McBride, 2007) Efforts to promote poisoning preventive measures include child safe storage of medications such as placing them above the adult eye level and locking the cabinet at all times. Past research showed a large variation in characteristics of parents and guardians who do not store medication safely from children. To develop effective intervention strategies of leaving medication unsecured and improve parental safety behavior, more insight on the underlying psychosocial mechanisms and modifiable mediators are needed. Safety and health promoting behaviors are influenced by complex interrelated sets of so-called behavior mediators or determinants. They include cognition and environmental factors. Behavior can be determined through using behavioral and protective motivation theories. This knowledge will be crucial in explaining certain behavior and going beyond basic unchangeable risk factors such as socioeconomic status. To date little knowledge exists on behavioral theories and unintentional injury while protective motivation theory explains interventions of preventive and precautionary behavior. Protection motivation theory explains the probability of health protective behavior or adaptive response in child safe storage as increased by four beliefs namely • the threat perceived as severe, • vulnerability • adaptive response is perceived (response efficacy) • personal abilities and self-confidence perceived as self-efficacy The probability of adaptive response decreases with perceived rewards of the maladaptive response. For example, not using safety locks as the perceived barriers are costs (pros and cons of safe behavior). This model was adopted for the study to assess the influence of personal cognitions and safety behavior attitudes. Psychosocial correlates of parental behaviors concerning unintentional poisoning from medications left unsecured among parents of toddlers between 11-18 months, to determine the most imperative factors of safe storage of medications. A model based on the PMT theory and additional social variables was applied (Bierens, 2010).
Ethical considerations for data collection An informed consent form was given to all participants to sign. The consent included information on discretion and confidentiality of the data collected through questionnaires. No financial incentives were given to parents and they were expected to participate willingly. The information given by participants was useful for data collection of the research only and would be processed anonymously. Participants of this research were informed about the research objectives as home safety issues of medications before the onset of the research. The family members or parents all received pre survey from health care providers. This also informed them about the research. The recruitment of participants was done amongst parents of children aged 11-18 months. The participants were all part of the sample of six preventive healthcare providers. They were all from both the rural and urban parts of Netherlands, and were invited to healthcare centers to fill mailed questionnaires. Data collection methods included questionnaires and PMT constructs. The questionnaires were 160 questions addressing the safeness of how the medication was stored from children. Variable included standard socio-demographics and the correlation of the drugs safe storage behavior was measured in PMT constructs. They were developed as pilot tests were done among 25 parents, then refined based on interviews. Safety behavior was measured through asking whether respondents stored various products on the floor, table, and drawer without locking or safety catches. Potential correlates of safety behavior were mainly based on protection motivation theory to assess the influence of personal cognitions and parental safety attitude behavior. PMT constructs measured perceived vulnerability by asking respondents about their perception of the child accidentally swallowing medicine (-2=low risk; =2=high risk0. Perceived severity was measured with one item (-2=not serious; =2=very serious) while response efficacy asked about for thoughts on storing products out of reach of children as preventive in possible accidents (-2=not too helpful; +2=very helpful). All assessments on PMT and psychosocial constructs were measured on bipolar five point scales.
Statistical analysis The study showed a strong association of unintentional poisonings with safe storage of the medications. Through perceived vulnerability, perceived disadvantages of safety behavior, self-efficacy and descriptive norm associations with unsecured medication was evident. It can be concluded that through this study, the PMT model is applicable in predicting safety of storing medication. The associations with psychosocial correlates results revealed that safe storage of medications were reported by 74.4% and 60.5% of the respondents. Differences between safe and unsafe storage results revealed that respondents who stored the medications in a child safe manner had a significantly lower perceived vulnerability, advantages of safe behavior and more positive social influences asserts Beirens (2010).
An evaluation on the information of this specific study Information on leaving medication insecure and its consequences like unintentional poisonings amongst toddlers has not been intensive. Though some scholars have carried out medical researches on safety of medicine and safety precautions, research on medication safety in the households is not thorough. This research specifically had limitations that need to be addressed. To start with, the study relied on self-report of medication and by parents and misclassification may have occurred. Parents may have for example, given socially desirable answers like overstating safe storage and supervision of children when products were stored unsafely. Moreover, they may also have been aware of unsecured medications at home but still left it unsafely. Such parents perceived their children as more vulnerable to possible unintentional poisoning than parents who store medication safely. The research assess and includes storage practices of parents related to medications and no information on child supervision. There is a need for more research on leaving medication unsecured and its effects on other age groups like teenagers, adults or the elderly. According to Betar (2012), the availability of unsecured drugs at home accounts for 90% of all teenage drug abuse. Further research on leaving medication unsecured will help gather data on the impact of unsafe medications at home can cause. Leaving medications unsecured in other facilities like schools and hospitals are other areas of study that can significantly improve research in the medical field.
Summary of conclusions At home, accidental use of unsecured drugs is on the rise. Kids and infants are vulnerable and may take medication that is left carelessly unsecured. Parents need to practice safety measures at all costs to protect children and make households safe especially for toddlers. Preventive measures like storage of medications in locked cabinets are a crucial step. According to Parran (2001), strategies to promote safe medication practice include labeling all drugs and keeping them out of reach of children. Improving medication safety is not only a requirement but also a safety precaution that we all need to take.

References
Betar, T. (2012). Prescription drug abuse tragedies impact many as epidemic continues, Desert News, from http://www.deseretnews.com/article/865560775/Prescription-drug-abuse- tragedies-impact-many-as-epidemic-continues.html?pg=all Bierens, T. Beecke, E, Brug, J. Hertog, P. and Raat, H.(2010). “Research article; Why do parents with toddlers store poisonous products safely?” International journal of pediatrics, Hindawi publishing coorp. Vol.2010. 8pp.
Malloch, K. & Porter, T.(2009). The handbook on storing and securing medications, 2nd ed. American journal of health system pharmacy, 66(21), 1957-58
McBride, K. & Maralyn, F. (2007). “A secondary care nursing perspective on medication administration safety,” Journal of advanced nursing, 6091), 58-66 doi:10,111/j1365- 2648.2007.04378
Parran, L. (2001). Shared stories light the way to safe medication practices, ONS News,16(7),1 From http://eds.b.ebscohost.com.library.gcu.edu:2048/eds/pdfviewer/pdfviewer?sid=df5b041c- dff5-44bc-a6e5-32ed0c7c9224@sessionmgr111&vid=1&hid=113

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