Assessing medication safety culture in Norwegian pediatric wards: a first nationwide survey

Health information technologies are widely used in hospitals to reduce the risk of medication errors. However, evidence on their impact on medication management and patient safety in pediatric settings remains limited. The aim of this study was to assess safety culture in medication management and medication error reporting in pediatric wards and to identify areas for improvement.

A survey was developed and presented on the annual meeting of Medicines for Children Network, Norway, attended by 80 physicians, pharmacists, and nurses. Following adjustments, the questionnaire was piloted with two physicians, three pharmacists, and three nurses. The survey was then distributed by e-mail to all pediatric wards in Norway. We used the SEIPS (Systems Engineering Initiative for Patient Safety) model to guide the analysis.

In total 102 nurses, 24 physicians and seven pharmacists responded, representing 19 out of the 22 (86%) pediatric wards. Access to health information technology adapted to pediatrics, including electronic health records, electronic medication administration records, and clinical decision support systems, varied across hospitals and across stages of the medication management process. Respondents generally agreed that a well-established reporting culture promotes learning. A majority also expressed a need for greater involvement in the review of reported medication errors, and more extensive training regarding patient safety and reporting culture.

Hospital staff demonstrated generally positive awareness of pediatric patient safety. Medication management seemed to be affected by the ongoing implementation of new health information technology, suggesting opportunities for better health information technologies adapted to pediatric wards. Persistent barriers to medication error reporting may limit opportunities for learning and improvement.