High alert medications administration errors in neonatal intensive care unit: A pediatric tertiary hospital experience

Abstract

Changing nurses' culture of safety and increasing error reporting, then investigating the common causes of error, particularly those associated with high-risk medications, will finally improve medication safety at neonatal intensive care units (NICU). This study aims to assess nurses' knowledge and practices during the administration of high alert medications (HAM). This is a hospital-based descriptive cross sectional study, implemented in the NICU, at Cairo University Pediatric hospital. A convenient sample of 33 bedside NICU nurses, who agreed to participate was recruited. A valid, reliable questionnaire was used to measure NICU nurses' general and specific knowledge regarding five therapeutic HAM. An observational checklist was used to assess nurses' administration practices. Both revealed that the mean percentage score of the nurses' knowledge (76.2±11.6) was higher than the mean percentage score of their total practice (69.1±13.3). Analysis of types of nurses' errors, showed that the most common error type was the wrong dose (15%), followed by wrong drug type (13.6%). Nurses' knowledge and training are not mandatorily interpreted into improved implementation practices. Interventions highlighted for preventing HAM errors were developing specific training on HAM for nurses and establishing neonate centered, multidisciplinary teams formed of physicians, nurses, and pharmacists.