الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Children safety is a central concern of current health-care delivery
systems worldwide, medication safety is an important part of this safety
and is an indicator of health care quality (WHO, 2017).Safe and effective
medication administration requires that nurses have the necessary skills
and competencies to deliver high quality care and prevent medication
errors (Kim et al., 2013). Medication errors and adverse drug events are
common in pediatric patients’ wards and in particular children with
multiple medications or have longer hospital stays and those with co-
morbidities, were at greater risk for medication errors or adverse drug
events .These errors can significantly affect children safety and result in
hazards for children and their families, so medication safety process aims
at the reduction of medication errors rates and their earlier identification
before the child gets harmed (Dedefo et al., 2016).
Pediatric medication errors can be reduced through multiple
interventions aimed at improving the medication process and maintaining
children safety (Kahn et al., 2018). Pediatric nurses have a key role in
monitoring, notifying, education and prevention of these errors.
Implementation of a structured educational intervention and counseling
for health professionals and nurses play an important role in reduction of
medication errors rate (Wong et al., 2009). Prevention of medication
errors is not simple. So, analyzing its causes help in their prevention,
whether by reviewing the work processes, training nurses and health
professionals, incorporating technological resources, developing
educational methods, tools, and creating protocols to enhance children
safety.Also, attention should be directed to the other aspects which causing medication errors such as lack of nurses, work load, nurses’
attitude, low wages and environmental factors (Yamamoto et al., 2011).
The purpose of the study was to:-
1. Elicit of proposed protocol for safety medication administration.
2. Evaluate the effect of proposed protocol for nurses on children
medication safety.
Research design:-
A quasi- experimental design (Pre, Post and follow up tests) was
used.
Setting:-
This study was conducted in the pediatric wards at EL Menoufia
University Hospital and Shebin El_kom Teaching Hospital.
Subjects:-
A convenience sample of 50 nurses was obtained from the
previously mentioned settings (35 nurses from the pediatric ward at
Menoufia University Hospital and 15 nurses from the Pediatric Ward at
Shebin El_kom Teaching Hospital).
Instruments of the study:-
Three instruments were utilized for data collection:
Instrument one: Structured interviewing questionnaire: It was divided
into two parts:
Part one: Social characteristics of studied nurses.
Part two: structured questionnaire to identify nurses’ knowledge
about medication administration, causes of medication errors, causes
of not reporting these errors and strategies for prevention of these
errors.
Instrument two: Structured Observation form for direct observations(medication observation form). It is developed by Harkanen (2014) and
modified by the researcher. It was used to observe nurses’ during
preparation and administration of medication and detecting medication
errors.
Instrument three: medication safety audit list for nurses: It was
developed by ministry of health of singapore (2006) and modified by the
researcher. It was used to assess children medication safety.
The main results of the study showed that:
1- More than half of studied nurses (60.6%) were ≥30 years old.
2- All of studied nurses (100%) did not attend any previous training
courses related to medication safety.
3- Less than half of studied nurses (46%) were graduated from
Technical Nursing Institute.
4- More than half of studied nurses (60%) had ≥5 years of experience in
Pediatric Nursing.
5- Total mean scores of nurses’ knowledge about medication errors on
pretest were 8.02 ± 3.7 compared to 13.64 ± 2.09 and 12.58 ± 1.6 on
post and follow-up tests respectively.
6- Total mean scores of nurses’ knowledge about different routes of
medication administration (oral, IM, IV, SC) were 16.82 ± 4.6 on
pretest compared to 23.34 ± 2.8 and 23.14± 1.6 on post and follow-up
tests respectively.
7- Total means scores of medication observation form were 14.84 ± 1.4
on pretest compared to 16.80 ± 1.7 and 14.82 ± 0.96 on post and
follow-up tests respectively.Total mean scores of nurses ’knowledge about medication safety audit
list were 6.64 ± 0.67 on pretest compared to 9.1 ± 0.71 and 8.1 ± 0.86
on posttest and follow-up test respectively.
9- There were positive correlation between total knowledge of nurses and
child medication safety
10- There were positive correlation between total knowledge of nurses
and total medication observation form
11- There were positive correlation between total medication safety
audit list and total medication observation form
The study concluded that:
Implementation of the proposed protocol for nurses on children
medication safety improved nurses’ knowledge and practices regarding
medication safety for pediatric patients. Also, it contributed to detect the
most common medication errors among pediatric nurses
Based on the results of the study it was recommended that:
1. Ongoing in-service education programs about children medication
safety should be designed and implemented at all pediatric units to
improve pediatric nurses’ knowledge and practices on the basis of
nurse’s actual needs.
2. Proposed protocol regarding medication safety should be used by
pediatric nurses in all pediatric units.
3. In service training units should be established in each hospital to
enhance nurses’ knowledge and practice regarding medication safety.
4. Future studies should be applied on a larger sample to investigate
the effect of proposed protocol for nurses’ on children medicationsafety to ensure generalizability of the results, and should be a part of
health care provided in all hospitals.