Introduction
Nursing drug errors in pediatric care create significant challenges to the safety of patients and the quality of health care. Medical errors globally cause adverse events, complications, and hospitalization, and some effects are fatal. Nurses are directly involved in medication administration; therefore, they should ensure the safety of the patient and the accurate delivery of drugs to pediatric patients. Medical errors occur due to the following reasons; lack of knowledge, communication challenges, and patient mistakes. Medical errors are a global concern; thus, understanding the current state of nursing drug errors in pediatric care is crucial in implementing interventions to foster patient safety and positive healthcare outcomes (Alghamdi et al., 2019).
Prevalence of Nursing Drug Errors
Several studies have been conducted to investigate the prevalence of nursing drug errors in pediatric care in the United States. According to research, approximately 10% of pediatric inpatient medication errors occurred, with two-thirds of the errors attributed to adverse drug effects. Children hospitalized are experiencing medication-related harm or injuries, but it is important to note that medical errors may not necessarily result in harm. According to other studies, about 7.5 million preventable medication errors occur with pediatric patients in the United States each year, raising many concerns about children’s safety while undergoing treatment (Derrico et al., 2022).
Common Types of Nursing Drug Errors in Pediatric Care
Nursing drug errors in pediatric care have negative implications on the life of children due to unique physiological characteristics and variations in drug response Nurses are at the center of administering medication to children, but errors may occur at different stages of the medication process .the nursing drug errors are as follows: dosing and calculation errors in which medication in pediatric are weight-based taking into account the age and surface area of the child. Nurses may miscalculate dosage due to a lack of familiarity with pediatric reference sources resulting in an overdose or underdose. Documentation and communication errors among healthcare professionals occur when a nurse must communicate clearly on medication or misinterpreting written or verbal prescriptions. Poor documentation may result in inaccurate timing and dosage, resulting in subsequent challenges in monitoring the patient’s response (Marufu et al., 2022).
Administration and medication preparation errors are likely due to interruptions and multitasking on more activities. Inaccurate measurement in liquid treatment due to misreading markings leads to dosing errors. Administration errors such as wrong route, for example, intravenous instead of oral, may result in medication errors. A sound-alike medication or look-alike error occurs due to similar naming, and nurses are likely to confuse medication resulting in the wrong drug. Allergy of drug errors due to adverse reactions to a given medication. If the nurse fails to check the allergy history may cause severe injury or harm to the child. Lack of information concerning drug interaction may lead to adverse implications, therefore, putting the child’s life at risk (Marufu et al., 2022).
Causes of Nursing Errors in Pediatric
Nursing errors in pediatric care are likely to cause injury or death to children; therefore, understanding the causes or factors behind nursing errors is essential. The nursing errors are attributed to the complexity of pediatric nursing, the vulnerability of the pediatric population, and the risks or challenges nurses face while doing their duties. The causes of nursing errors are as follows: lack of pediatric–specific education and training leading to inadequate knowledge and skills. Pediatric knowledge helps in understanding growth and development, medication dosages, and age–appropriate assessments, hence avoiding medication errors in children (Schroers et al., 2021).
Communication breakdown or barriers may hinder the adequate flow of information among healthcare stakeholders such as nurses, doctors, parents, and even the child. Miscommunication results in nursing errors in treatment plans, administration of medication, and medical procedures. The child is exposed to fatal risks to critical organs such as the heart, brain, and lungs, and communication breakdown occurs. Communication breakdown may occur due to Language barriers, cultural differences, and beliefs. Medication errors occur due to the complexity of pediatric medication calculations and adjustments of doses administration of medication, especially in non-standardized formats. Inappropriate conversions may lead to errors in dosage and adverse effects of the drugs, such as reactions (Schroers et al., 2021).
Staffing and workload issues, such as inadequate staffing, result in increased nurse-to-patient ratios leading to heavy workloads. Nurses, therefore, suffer from fatigue, stress, and low concentration while delivering services. Nurses are forced to work long hours, negatively affecting their morale. Nurses, therefore, suffer from impaired judgment and inability to provide much-needed care to the patient hence increasing the risk of errors. Distractions and interruptions are associated with pediatric care settings due to high activity levels and frequent interruptions. Nurses are likely to be distracted, resulting in missed assessments, inaccurate documentation, interruption from technology, and noise from the environment, which affect the level of concentration (Schroers et al., 2021).
Inadequate documentation may cause missed treatments, incorrect medical procedures, and incomplete information about the patient. Healthcare workers need help to obtain adequate information on the patient’s medical history, such as reactions to certain drugs. Incomplete information about the patient may be attributed to time constraints, heavy workloads, and the absence of standardized documentation practices, which directly contribute to inconsistent records .thus nurses are not in a position to make quick and accurate decisions leading to medical errors. The need for standardized protocols in healthcare organizations results in variations in medical procedures. Nurses, therefore, need clarification during medical administration, use of equipment, and treatment plans (Schroers et al., 2021).
Failure to involve parents and family in pediatric care may lead to nursing drug errors. Overlooking parental involvement may lead to treatment decisions, medication administration, and follow-up care errors. Lack of parental involvement may occur due to inadequate education and cultural diversity undermining active participation in treatment. Parents or family members may give information concerning the patient’s medical history that could help healthcare workers make informed decisions critical to the treatment plan (Schroers et al., 2021).
Nursing drug errors may occur due to the influence of drug abuse on healthcare workers due to the following reasons: impaired judgment that affects reasoning and decision-making process. When the level of attention and concentration is low, nurses are easily distracted, making them forgetful and therefore administering the wrong medication. Drugs impair motor skills and coordination, leading to the inability to medication properly; therefore, spillover or incorrect preparation may occur. Drug abuse affects memory and processing of information; hence nurses find it challenging to remember critical information in administering the drug leading to medical errors (Schroers et al., 2021).
Side Effects of Nursing Drug Errors
Nursing drug errors have the following side effects: adverse drug reactions due to incorrect dosage or administration, resulting in adverse reactions ranging from mild symptoms to severe effects like organ damage. Medication infectiveness, especially when medication is not administered correctly or in the wrong dosage, leads to prolonged sickness, and the child may stay longer in the hospital. Medication toxicity due to overdose may harm or injure body organs. Drug-resistant infection, especially for antibiotics drugs, if they are not prescribed correctly hence making infection more difficult to manage and treat. Nursing drug errors cause psychological disturbance attributed to the drug’s adverse effects, leading to fear and mistrust of the medication process (Lilley et al., 2022).
Mitigating Nursing Drug Errors
Nursing drug errors can be overcome through training and educating nurses to acquire knowledge and skills critical in understanding dosage calculation, correct administration of drugs, and interaction of drugs—the creation of standardized procedures and medication protocols help minimize errors. Clear directions are essential in preparing and administering medication. Effective communication among healthcare stakeholders and nurses should seek clarification from doctors or physicians who prescribe drugs for children. Nurses should effectively relay information to the patient concerning their medication and address issues raised by patients. Adopting technology such as electronic health records and barcode scanning machines helps promote medication accuracy and safety. Automated alerts detect potential allergies and drug interactions (Lilley et al., 2022).
References
Alghamdi, A. A., Keers, R. N., Sutherland, A., & Ashcroft, D. M. (2019). Prevalence and nature of medication errors and preventable adverse drug events in pediatric and neonatal intensive care settings: a systematic review. Drug safety, p. 42, 1423-1436.
Derrico, S., Zanon, M., Radaelli, D., Padovano, M., Santurro, A., Scopetti, M., … & Fineschi, V. (2022). Medication errors in pediatrics: proposals to improve the quality and safety of care through clinical risk management. Frontiers in Medicine, 8, 814100.
Lilley, L. L., Collins, S. R., & Snyder, J. S. (2022). Pharmacology and the nursing process E-Book. Elsevier health sciences.
Marufu, T. C., Bower, R., Hendron, E., & Manning, J. C. (2022). Nursing interventions to reduce medication errors in pediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 62, e139-e147.
Schroers, G., Ross, J. G., & Moriarty, H. (2021). Nurses’ perceived causes of medication administration errors: a qualitative systematic review. The Joint Commission Journal on Quality and Patient Safety, 47(1), 38-53.
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