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Reporting of medication errors by pediatric nurses
Karen M Stratton1, Mary A Blegen, Ginette Pepper
1School of Nursing, University of Colorado Health Sciences Center, Denver, CO, USA.
Insights
Pediatric medication errors are reported more frequently and occur at higher rates than in adults. Distractions, staffing, and fear of consequences contribute to medication administration errors and underreporting in nursing care.
Area of Science:
- Nursing
- Patient Safety
- Pediatric Care
Background:
- Medication administration errors pose risks to patient outcomes.
- Children's unique physiology increases their vulnerability to medication errors.
- Understanding medication errors in pediatric nursing is crucial for patient safety.
Purpose of the Study:
- To compare medication error reporting and occurrence rates between pediatric and adult hospital units.
- To identify perceived causes of medication errors in pediatric nursing.
- To explore reasons for underreporting of medication errors by nurses.
Main Methods:
- Descriptive study utilizing a convenience sample of 57 pediatric and 227 adult hospital nurses.
- Survey assessed nurses' perceptions of medication error reporting proportions, causes, and underreporting.
- Analysis focused on pediatric data in comparison to adult unit data.
Main Results:
- Pediatric nurses reported a higher proportion of medication errors (67%) compared to adult nurses (56%).
- Medication error rates were significantly higher in pediatric units (14.80 per 1,000 patient-days) versus adult units (5.66 per 1,000 patient-days).
- Key factors identified for errors included distractions, interruptions, and RN-to-patient ratios; underreporting was linked to administrative focus on individuals and fear of reprimand.
Conclusions:
- Pediatric units experience higher rates of reported medication errors and actual occurrences.
- Systemic factors like staffing and interruptions, alongside reporting barriers, require attention.
- Addressing both individual and systemic safeguards is essential to mitigate medication errors and improve reporting in nursing.
Abstract:
Medication administration errors can threaten patient outcomes and are a dimension of patient safety directly linked to nursing care. Children are particularly vulnerable to medication errors because of their unique physiology and developmental needs. This descriptive study surveyed a convenience sample of 57 pediatric and 227 adult hospital nurses regarding their perceptions of the proportion of medication errors reported on their units, why medication errors occur, and why medication errors are not always reported. In this study, which focuses on pediatric data, pediatric nurses indicated that a higher proportion of errors were reported (67%) than adult nurses indicated (56%). The medication error rates per 1,000 patient-days computed from actual occurrence reports were also higher on pediatric (14.80) as compared with adult units (5.66). Pediatric nurses selected distractions/interruptions and RN-to-patient ratios as major reasons medication errors occurred. Nursing administration's focus on the person rather than the system and the fear of adverse consequences (reprimand) were primary reasons selected for not reporting medication errors. Results suggest the need to explore both individual and systematic safeguards to focus on the reported causes and underreporting of medication errors.
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