Nurses’ Knowledge and Practices Regarding Safe Medication Administration at The Children’s Hospital, Lahore

Abstract

Background: Pediatric medication administration is highly error-prone due to weight-based dosing and formulation complexity, making nurses’ knowledge and bedside behaviors pivotal to patient safety. Evidence from Pakistan suggests gaps between reported awareness and actual practice, with limited pediatric-specific data from tertiary-care settings (1-3,9-12). Objective: To assess nurses’ knowledge and self-reported practices regarding safe medication administration in a pediatric tertiary-care hospital and examine associations with demographic and professional characteristics. Methods: A descriptive cross-sectional study was conducted among registered nurses at The Children’s Hospital and Institute of Child Health, Lahore (May-October 2025). Stratified random sampling across medical, surgical, and emergency units yielded 61 participants. A validated, self-administered questionnaire (15-item knowledge; 15-item practice; five-point Likert scales) was used. Internal consistency was evaluated with Cronbach’s alpha. Group comparisons used Mann-Whitney U and Kruskal-Wallis tests with post hoc pairwise analysis for significant findings. Results: Participants were predominantly female (96.7%) and early-career (90.2% aged 18-25). Mean knowledge and practice scores were 4.10±0.75 and 4.24±0.62, respectively; alphas were 0.845 (knowledge) and 0.885 (practice). Practice scores differed significantly by experience (H=7.89, p=0.019; η²≈0.12), with nurses >10 years exceeding those <1 year (p=0.016). No significant differences were observed by gender, marital status, or qualification. Conclusion: Nurses reported high knowledge and favorable practices; greater clinical experience was associated with stronger adherence to safe medication administration. Competency-based induction, simulation-enhanced refreshers, and just-culture reporting systems are recommended to consolidate safety behaviors.