Evaluation of Medication Administration Process in a Paediatric Ward

Authors: Zayed N. Alsulami, Asma F. Aldosseri, Ahmed S. Ezziden, Abdulrahman K. Alonazi

Abstract:

Children are more susceptible to medication errors than adults. Medication administration process is the last stage in the medication treatment process and most of the errors detected in this stage. Little research has been undertaken about medication errors in children in the Middle East countries. This study was aimed to evaluate how the paediatric nurses adhere to the medication administration policy and also to identify any medication preparation and administration errors or any risk factors. An observational, prospective study of medication administration process from when the nurses preparing patient medication until administration stage (May to August 2014) was conducted in Saudi Arabia. Twelve paediatric nurses serving 90 paediatric patients were observed. 456 drug administered doses were evaluated. Adherence rate was variable in 7 steps out of 16 steps. Patient allergy information, dose calculation, drug expiry date were the steps in medication administration with lowest adherence rates. 63 medication preparation and administration errors were identified with error rate 13.8% of medication administrations. No potentially life-threating errors were witnessed. Few logistic and administrative factors were reported. The results showed that the medication administration policy and procedure need an urgent revision to be more sensible for nurses in practice. Nurses’ knowledge and skills regarding to the medication administration process should be improved.

Keywords: Double checking, Medication administration errors, Medication safety, Nurses.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1337775

References:

[1] R. Kaushal, D.W. Bates, C. Landerigan, et al. “Medication errors and adverse drug events in pediatric inpatients”, Journal of American Medical Association, vol 285, pp. 2114 – 2120, 2001.
[2] E. Cowley, R. Williams, D. Cousins. “ Medication errors in children: a descriptive summary of medication error reports submitted to the US pharmacopeia”, Current Therapeutic Research, vol 62, no. 9, pp. 627 – 640, 2001.
[3] E. Fortescue, R. Kaushal, C. Landrigan, et al. “Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients”. Pediatrics, vol 111, pp. 722 – 729, 2003.
[4] M. Miller, K. Robinson, L. Lubomski, “Medication errors in paediatric care: a systematic review of epidemiology and an evaluation of evidence supporting reduction strategy recommendations”. Quality and Safety in Health Care, vol 16, pp. 116 – 126, 2007.
[5] M. Ghaleb, N. Barber, B. Franklin, I. Wong. “The incidence and nature of prescribing and medication administration errors in paediatric inpatients. Archives of Disease in Childhood, vol 95, pp. 113 – 118, 2010.
[6] K. Gonzales, “Medication administration errors and the pediatric population: a systematic search of the literature”, Journal of Pediatric Nursing, vol 26, pp. 555 – 565, 2010.
[7] Z. Alsulami, S. Conroy, I. Choonara, “ Medication errors in the Middle East countries: a systematic review of the literature”, European Journal of Clinical Pharmacology, vol 69, pp. 995 – 1008, 2013.
[8] K. Barker "Dat collection techniques: observation", Amrican Journal of Hospital Phrmacy, vol. 37, pp. 1235 – 1243, 1980.
[9] E. Allan, K. Barker, "Fundamentals of medication errors research" American Journal of Health System Pharmacy, vol. 47, pp. 555 – 571, 1990.
[10] Z. Alsulami, I. Choonara, S. Conroy, " Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: an observational study", Journal of advanced Nursing, vol.70, pp. 1404 – 1413, 2014.
[11] S. Chua, M. Hui, A. Omar, "Drug administration errors in paediatric wards: a direct observation approach", European Journal of Pediatrics, vol. 169, pp. 603 – 611, 2010
[12] B. Franklin, K. O'Grady, P. Donyai, et al. "The impact of a closed-loop electronic prescribing and administration system on prescribing errors, aministration errors and staff-time: a before – and – after study, Quality and Safety in Health Care, vol. 16, pp. 279 – 284, 2007.
[13] J. Westbrook, A. Woods, M. Rob, et al. "Association of interruptions with an increased risk and severity of medication administration errors, Archives of Internal Medicine, vol. 170, pp. 683 – 690, 2010.