Background 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 the aetiology and detection of unsafe care. Aim To explore how and in what circumstances parents may inadvertently contribute to or help mitigate against paediatric patient safety incidents in general practice. Design & setting We conducted a cross-sectional exploratory descriptive analysis of paediatric patient safety incidents occurring in general practice, with explicit evidence of parental involvement, between September 2014 and February 2023. Method General practitioners 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. Results Of 374 reports included, most reports described mitigatory actions by parents (n=287,76.7%). Parents frequently mitigated incidents relating to medications (e.g., 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 (54.5%, n=156). Conclusion The actions of parents have a direct impact on paediatric safety within general practice. We 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.
Purchase et al. (Thu,) studied this question.