Reporting of Medication Errors by Pediatric Nurses

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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.

Section snippets

Sample

This study was a pilot study conducted as part of a nationwide study of nurse staffing and quality of care in 300 adult patient care units in 50 hospitals currently in progress (Blegen & Vaughn, NINR NR01 04937). Because of concerns about the accuracy of medication administration error data from voluntary reporting of occurrences, the investigators developed a questionnaire for distribution to staff nurses in hospitals asking them to estimate the extent of occurrence reporting related to

Results

This report focuses on the responses from nurses on pediatric units. Analysis by type of unit was not performed because there were too few units of any particular specialty. Comparisons with responses from adult units are used to enhance interpretation.

Discussion

Study results indicated a difference in medication error rates between pediatric and adult units, based on documented occurrence reports of 14.80 per 1,000 patient-days on pediatric versus 5.66 per 1,000 patient-days on adult units. However, findings from this study also suggest that medication administration error occurrences are underreported. The overall average estimate of medication error reporting on pediatric units was 67%. This is in contrast to the 56% found on adult patient units.

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