Medication errors in pediatric nursing: assessment of nurses' knowledge and analysis of the consequences of errors.

AIM: The purposes of this study were (i) to evaluate pediatric nurses' knowledge of pharmacology, and (ii) to analyze known pediatric administration errors. BACKGROUND: Medication errors occur frequently and ubiquitously, but medication errors involving pediatric patients attract special attention for their high incidence and injury rates. METHODS: A cross-sectional study was conducted. A questionnaire with 20 true-false questions regarding pharmacology was used to evaluate nurses' knowledge, and the known pediatric administration errors were reported by nurses. FINDINGS: The overall correct answer rate on the knowledge of pharmacology was 72.9% (n=262). Insufficient knowledge (61.5%) was the leading obstacle nurses encountered when administering medications. Of 141 pediatric medication errors, more than 60% (61.0%) of which were wrong doses, 9.2% of the children involved suffered serious consequences. CONCLUSIONS: Evidence-based results demonstrate that pediatric nurses have insufficient knowledge of pharmacology. Such strategies as providing continuing education and double-checking dosages are suggested.

Nurses' knowledge of high-alert medications: a randomized controlled trial.

AIM: This study explores the effectiveness of an educational intervention on nurses' knowledge regarding the administration of high-alert medications. BACKGROUND: Nurses' insufficient knowledge is considered to be one of the most significant factors contributing to medication errors. Most medication errors cause no harm to patients, but the incorrect administration of high-alert medications can result in serious consequences. A previous study by the same authors validated 20 true/false questions concerning high-alert medications and suggested that the topic be taught to nurses (Hsaio, et al., 2010. Nurses' knowledge of high-alert medications: Instrument development and validation. Journal of Advanced Nursing, 66(1), 177-199.). METHODS: A randomized controlled trial was employed in 2009 in Taiwan. Twenty-one hospital wards and 232 nurses were randomized to control and intervention groups. The sixty-minute educational intervention was based on the viewing of a Powerpoint file developed for this study. The results were compared pre-intervention and six weeks post-intervention by means of a test comprising the 20 questions regarding high-alert medications. FINDINGS: The pre-intervention baseline data for correct answer rate was 75.8% (mean; n=232). After the intervention, the post-test showed significant improvement in the intervention group (n=113) (pre vs. post; 77.2±15.5 vs. 94.7±7.6; paired t=10.82, p<0.0001) but not in the control group (n=112) (pre vs. post; 74.3±14.7 vs. 75.5±14.2; paired t=0.60; p=0.247). CONCLUSIONS: Educational intervention appears to be effective in strengthening nurses' knowledge of high-alert medications. The Powerpoint file presented teaching material which is both suitable and feasible for hospital-based continuing education.

[Medication errors in emergency rooms, intensive care units and pediatric wards].

Medication safety is a major concern worldwide that directly relates to patient care quality and safety. Reducing medication error incidents is a critical medication safety issue. This literature review article summarizes medication error issues related specifically to three hospital units, namely emergency rooms (ERs), intensive care units (ICUs), and pediatric wards. Time constrains, lack of patient history details and the frequent need to use rapid response life-saving medications are key factors behind high ER medication error rates. Patient hypo-responsiveness, complex medication administration and frequent need to use high-alert medications are key factors behind high ICU medication error rates. Medication error in pediatric wards are often linked to errors made by nurses in calculating dosage based on patient body weight. This article summarizes the major types of medication errors reported by these three units in order to increase nurse awareness of medication errors and further encourage nurses to apply proper standard operational procedures to medication administration.