Related Experiment Video
Updated: Jul 1, 2025
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Risk Factors Associated with Medication Administration Errors in Children: A Prospective Direct Observational Study
Johanna I Westbrook1, Ling Li2, Amanda Woods2
1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, New South Wales, 2109, Australia. Johanna.westbrook@mq.edu.au.
Insights
Medication administration errors (MAEs) are common in paediatric wards, particularly with intravenous medications and in older children. Electronic medication management systems significantly reduce harm from these errors.
Area of Science:
- Paediatric Nursing
- Medication Safety
- Health Informatics
Background:
- Limited data exists on medication administration errors (MAEs) and their risk factors in general paediatric settings.
- Understanding these factors is crucial for improving patient safety.
Purpose of the Study:
- To identify nurse, medication, and work-environment factors associated with MAEs in paediatric inpatients.
- To assess the impact of electronic medication management systems on MAEs.
Main Methods:
- Prospective, direct observational study of 298 nurses and 5137 medication administrations in a paediatric hospital.
- Data collected on nurse characteristics, medication details, and work variables.
- Multivariable models used to analyze risk factors for MAEs.
Main Results:
- MAEs occurred in 37.0% of administrations, with 25.8% rated as potentially serious.
- High error rates observed for intravenous routes (64.7%) and injections (77.4%).
- Risk factors included intravenous route, early morning/weekend administration, older children, and oral medications needing solvents; electronic medication management systems reduced harm by 45%.
Conclusions:
- Medication error prevention should focus on intravenous administrations and older paediatric patients.
- Improving nurses' work environments and integrating medication technologies, like electronic medication management systems, is essential.
Introduction:
Limited evidence exists regarding medication administration errors (MAEs) on general paediatric wards or associated risk factors exists.
Objective:
The aim of this study was to identify nurse, medication, and work-environment factors associated with MAEs among paediatric inpatients.
Methods:
This was a prospective, direct observational study of 298 nurses in a paediatric referral hospital in Sydney, Australia. Trained observers recorded details of 5137 doses prepared and administered to 1530 children between 07:00 h and 22:00 h on weekdays and weekends. Observation data were compared with medication charts to identify errors. Clinical errors, potential severity and actual harm were assessed. Nurse characteristics (e.g. age, sex, experience), medication type (route, high-risk medications, use of solvent/diluent), and work variables (e.g. time of administration, weekday/weekend, use of an electronic medication management system [eMM], presence of a parent/carer) were collected. Multivariable models assessed MAE risk factors for any error, errors by route, potentially serious errors, and errors involving high-risk medication or causing actual harm.
Results:
Errors occurred in 37.0% (n = 1899; 95% confidence interval [CI] 35.7-38.3) of administrations, 25.8% (n = 489; 95% CI 23.8-27.9) of which were rated as potentially serious. Intravenous infusions and injections had high error rates (64.7% [n = 514], 95% CI 61.3-68.0; and 77.4% [n = 188], 95% CI 71.7-82.2, respectively). For intravenous injections, 59.7% (95% CI 53.4-65.6) had potentially serious errors. No nurse characteristics were associated with MAEs. Intravenous route, early morning and weekend administrations, patient age ≥ 11 years, oral medications requiring solvents/diluents and eMM use were all significant risk factors. MAEs causing actual harm were 45% lower using an eMM compared with paper charts.
Conclusion:
Medication error prevention strategies should target intravenous administrations and not neglect older children in hospital. Attention to nurses' work environments, including improved design and integration of medication technologies, is warranted.
More Related Videos
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
05:52Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Related Concept Videos
01:21Factors Affecting Drug Response: Overview
01:25Errors occurring during blood pressure monitoring
Several factors...
01:18Guidelines and Strategies for Safe Computer Charting
Maintain Confidentiality and Security:
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:30Guidelines for Nursing Documentation I
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
01:02Prescription, Nonprescription and Orphan Drugs
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...