THE ROLE OF NURSES IN ENSURING SAFE AND EFFECTIVE DRUG ADMINISTRATION TO CHILDREN IN HOSPITAL SETTINGS

TOPIC IS SUITABLE FOR:

1. Nursing Science Department

2. Pediatric Nursing Department

3. Public Health Nursing Department

4. Clinical Nursing Department

TOPIC: THE ROLE OF NURSES IN ENSURING SAFE AND EFFECTIVE DRUG ADMINISTRATION TO CHILDREN IN HOSPITAL SETTINGS

TABLE OF CONTENTS

Abstract

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study

1.2 Statement of the Problem

1.3 Objectives of the Study

1.4 Research Questions

1.5 Significance of the Study

1.6 Scope of Study

1.7 Operational Definition of Terms

CHAPTER TWO: LITERATURE REVIEW

2.1 Conceptual Review

2.2 Theoretical Review

2.3 Empirical Review

2.4 Summary of Literature Review

CHAPTER THREE: METHODOLOGY

3.1 Research Design

3.2 Research Setting

3.3 Target Population

3.4 Sample Size

3.5 Sampling Technique

3.6 Instruments for Data Collection

3.7 Validity and Reliability of Instrument

3.8 Pilot Study

3.9 Method of Data Collection

3.10 Method of Data Analysis

3.11 Ethical Considerations

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

4.1 Demographic Analysis

4.2 Analysis of Research Questions

CHAPTER FIVE: DISCUSSION OF FINDINGS

5.1 Key Findings

5.2 Implication of the Findings to Nursing

5.3 Limitations of the Study

5.4 Conclusion

5.5 Recommendations

5.6 Suggestion for Further Studies

Reference

Appendix

ABSTRACT

This study assessed the role of nurses in ensuring safe and effective drug administration to children in hospital settings using National Hospital Abuja (NHA)—Abuja as a case study. Specifically, the study aimed to examine the key responsibilities of nurses in pediatric drug administration, identify common challenges nurses face in ensuring safe medication practices for children, explore strategies and best practices for minimizing medication errors in pediatric care, and recommend improvements in hospital policies, training, and technology to enhance drug safety. The descriptive design was used. The sample population was 280 pediatric nurses at NHA, and the sample size of 165 respondents was selected by using a multi-stage sampling technique that involved stratified and simple random sampling. Information was collected through a structured questionnaire and analyzed by descriptive statistics such as mean and standard deviation, and a benchmark of 2.50 was used as a decision threshold. The results indicated that the nurses had high fidelity to the critical activities such as confirming patient identity (X² = 4.22), conducting proper dose calculations (X² = 4.31), and keeping accurate documentation (X² = 4.18). The most often mentioned issues were related to poor staffing (X = 4.25), the lack of age-appropriate formulations (X = 4.12), and frequent communication gaps (X = 4.10). The effective practice countermeasures were the adherence to the five rights of medication administration (X 29 = 4.29), the use of weight-based dosage recommendations (X 24 = 4.24), and the involvement in the regular in-service retraining (X 16 = 4.16). The areas of improvement were focused on incorporating more in-service pharmacology education (X̄ = 4.29), the introduction of electronic prescribing systems (X̄ = 4.19), and the development of protocols related to pediatrics (X̄ = 4.08). As a result, the research proposes the requirement to introduce pharmacology refresher courses, the use of electronic prescribing tools, and the improvement of interprofessional collaboration to support the safety of pediatric drug therapy.

Keywords: Pediatric Nursing, Drug Administration, Medication Safety, Electronic Prescribing, Pharmacology Training.

CHAPTER ONE

INTRODUCTION (Preview)

1.1 Background of the Study

The science of nursing is established on basic principles of ethics, compassion, and scientific practice and developed as a supporting role into a core element of health systems across the globe. Although the process of praxis is influenced by cultural, institutional, and scientific environments, the protection of vulnerable groups of people has been a central issue (Bell et al., 2023). The increasing complexity of modern service delivery, which is enhanced by advancing digital technologies and health crises around the globe, requires specific, sensitive, and responsible care. Pediatric care, characterized by the peculiarities of children's physiology and psychology, requires subtle clinical decision-making. Nurses working in the front line who perform medical orders need to merge technical accuracy with moral accountability. With the changing health care dynamics, the roles of nurses change accordingly, but the need to practice safe medication practice is the same regardless of the setting or patient population (Miotto et al., 2024; Schneidereith, 2021).

The process of medication administration, which people often consider a routine task, is one of the most risky jobs in pediatric nursing due to the increased susceptibility of children to pharmacological mistakes. Therapeutic accuracy is not limited to the routine filling of prescriptions: there is critical evaluation, dose determination, and careful monitoring. Children, with their inconsistent weight, age, and metabolism, require personalized drug treatment. Schneidereith (2021) argues that there is an analytical, anticipatory process of administering pediatric medication that makes the nurse the last line of defense against any possible harm. The nursing role in this regard presupposes the sphere of clinical judgment that is proactive and well-informed.

The safety of drug administration, furthermore, is based on effective communication among nurses, children, and families. As opposed to adult patients, children usually rely on caregivers and clinicians to express medical requirements and understand interventions. Afolalu et al. (2021) certify that the most important aspect of the development of trust and adherence is targeted therapeutic communication and education of families. High anxiety levels in hospitals expose children to psychological discomfort and poor clinical results. Kube

In addition to interpersonal competence, structural routines and interprofessional collaboration are other essentials of medication safety in pediatric wards. Nurses work in multidisciplinary teams where they translate, explain, and in some cases challenge medical orders in order to prevent errors. As Bell et al. (2023) point out, such standardized procedures as a double-checking system and observing the so-called five rights of administration are especially important when it comes to pediatric settings. Clinical governance should also offer sound training and autonomous decision-making, particularly when the calculations of the drugs are individualized. Rosyidi et al. (2024) claim that the confidence of the nurses in the interaction with physicians and pharmacists is a key to maintaining drug safety, especially in the cases of emergency pediatric settings and neonatal intensive care units.

Another characteristic of the nursing practice is the constant evaluation and observation of the medicine's effects. The personnel have to assess immediate and cumulative pharmacological effects, combining physiological findings with subjective measures to measure efficiency and identify early adverse effects. The inability to express discomfort adequately by children compounds this vigilance to make nursing surveillance an energetic process that requires comprehensive observation, recording, and responding to the situation at the right time. Miotto et al. (2024) note that such an initiative not only keeps children safe but, in addition, maintains efficient treatment because it offers proper feedback to the rest of the medical staff.

In the hospital setting in which the pediatric care is provided, the Nigerian health system serves as an example of why the special attention should be paid to the nursing practice to study it in the context of medication safety. Despite the universality of the principles, resource availability, pediatric-specific training, and local cultural perceptions of care are direct determinants of medication administration. Afolalu et al. (2021) remark that nurses working in most tertiary hospitals in Nigeria have to cope with heavy workloads and poor infrastructure but play a central role in maintaining drug safety. This research hence takes a critical evaluation of the standards, skills, and institutional aids that encompass pediatric drug administration among Nigerian nurses.

1.2 Statement of the Problem

The most important role in hospital-based nursing is the administration of medication to a pediatric patient. Quality control of pharmacotherapy in children requires not only a high professional level of knowledge of the specifics of pediatric pharmacology, clinical accuracy, and willingness to respond to the unique physiological and developmental characteristics of the population. In modern evidence-based practice, it is expected that nursing professionals should be both guided by the established protocols based on the empirical science and should respond to the individual variability of the pediatric health reactions (Miotto et al., 2024; Bell et al., 2023). In this duality, the nurse is not just a caregiver but a central agent in reducing risks that are involved in the administration of drugs. The nurse is central in the fulfillment of therapeutic objectives and in the facilitation of clinical safety in pediatric care environments by virtue of his or her positioning at the crossroad of children, families, and the healthcare system (Schneidereith, 2021; Kubešová et al., 2025).

Despite the recognized importance of nursing participation in pediatric drug administration, empirical studies show that there is a significant deviation from best practice in most hospital settings. The common ones are the errors in dosage, time errors, and documentation gaps that pose a threat to the safety of drugs in hospitals among the children. According to Afolalu et al. (2021), the error rates in administering medication are especially high on pediatric wards in low- and middle-income countries such as Nigeria, where systemic and professional factors interact to undermine safety. Similarly, Rosyidi et al. (2024) noted that, despite the common documentation of institutional protocols, their implementation is often unreliable, which allows a considerable margin of human error. Under these conditions, experienced nurses often come across institutional inefficiencies and poor support systems, a situation that can never produce results that are satisfactory according to the current safety standards.

The perfect management of children medication involves complete accuracy guided by pediatric pharmacology, following safety standards and maintaining institutional system with emphasis on continuous training and clinical auditing. However, such ideal is still far to be achieved in reality, particularly in most Nigerian hospitals, where the wide-spread inequality in the training, workload, and availability of resources limit its realisation. Bell et al. (2023) claim that although developed health systems have implemented numerous protective mechanisms (such as automated drug delivery systems and well-established interprofessional checks), most Nigerian hospitals continue to operate mainly manually, a situation that is vulnerable to mistakes. Further, Tsegaye et al. (2023) discovered that the poor incorporation of evidence-based practices and lack of pediatric-specific continuing education are also the sources of the actual disparities in safe medication administration.

Despite the fact that quite a few studies have been conducted on the safety of medications in general, there is still a significant lack of knowledge on how nurses in the Nigerian hospital setting specifically address the question of pediatric drug administration. KubeSova et al. (2025) underline that the localized practices, challenges, and facilitating factors found in a specific context should be studied in the context of intervention development to help it adapt to the realities of on-site work. Schneidereith (2021) agrees that although international statistics on the number of medication errors in pediatrics exist, there is a lack of understanding on how nurses address them in the limited settings. It is important to address this gap. The detailed description of the process of pediatric drug administration in Nigerian hospitals will help to design interventions that can improve the level of safety and efficiency. Therefore, this study tends to assess the role of nurses in ensuring safe and effective drug administration to children in hospital settings.

1.3 Objectives of the Study

The main objective of this study is to assess the role of nurses in ensuring safe and effective drug administration to children in hospital settings. Other objectives of this study are:

1. To examine the key responsibilities of nurses in pediatric drug administration.  

2. To identify common challenges nurses face in ensuring safe medication practices for children.  

3. To explore strategies and best practices for minimizing medication errors in pediatric care.  

4. To recommend improvements in hospital policies, training, and technology to enhance drug safety.

OTHER PARTS OF CHAPTER ONE INCLUDE:

1.4 Research Questions

1.5 Significance of the Study

1.6 Scope of Study

1.7 Operational Definition of Terms

CHAPTER TWO

LITERATURE REVIEW(Preview)

This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the contributions of scholars who had previously conducted studies on similar research topics. The chapter intends to deepen the understanding of the study and address the perceived gaps in existing literature. This chapter, therefore, focuses on the overview of pediatric hospitals in nigeria, concept of drug, concept of pediatric drug administration, physiological considerations in pediatric pharmacotherapy, etc. The chapter covers the following subheadings:

2.1 Conceptual Review

2.2 Theoretical Review

2.3 Empirical Review

2.4 Summary of Literature Review

CHAPTER THREE

RESEARCH METHODOLOGY  (Preview)

Research Design: The study adopted a descriptive research design.

Population of the Study: The population of the study comprises pediatric nurses at the National Hospital Abuja (NHA), assigned across wards and outpatient units.

Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 165 participants.

Sampling Technique: The study employed a multi-stage sampling technique combining stratified and simple random sampling methods to select the individual respondents.

Research Instrument: The study utilized a structured close-ended questionnaire as the instrument for data collection.

Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their opinions. The data were analyzed using SPSS and presented in tables, charts, and graphs for easy interpretation.

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

MAJOR FINDINGS (Preview)

The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that nurses at the National Hospital Abuja are highly aware of their key responsibilities in ensuring safe and effective drug administration to children, as evidenced by mean scores ranging from 4.02 to 4.36, which are above the acceptance benchmark of 2.50. The findings indicate that confirming the correct patient, verifying drug dosage and expiry dates, observing the five rights of medication administration, documenting drug administration, monitoring adverse drug reactions, and educating parents or guardians are recognized as essential nursing responsibilities.

ii. The study found that inadequate staffing, lack of pediatric-specific drug formulations, poor communication between doctors and nurses, high workload, inadequate training, and frequent interruptions during drug rounds are major challenges affecting safe medication practices for children at the National Hospital Abuja, as evidenced by mean scores ranging from 4.01 to 4.17, which are above the acceptance benchmark of 2.50. These findings indicate that staffing constraints, communication gaps, and limitations in training and medication resources may increase the risk of medication errors in pediatric care.

iii. The study found that the use of the five rights of medication administration, double-checking dosage calculations, weight-based dosing, accurate documentation, pharmacist involvement, and continuous training are important strategies for minimizing medication errors in pediatric care, as evidenced by mean scores ranging from 4.16 to 4.29, which are above the acceptance benchmark of 2.50. These findings indicate strong support for evidence-based practices to improve medication accuracy and patient safety.

iv. The study found that regular in-service training, electronic prescribing systems, updated hospital policies, barcode scanning, near-miss incident reporting, and pediatric-specific protocols are important improvements for enhancing drug safety at the National Hospital Abuja, as evidenced by mean scores ranging from 4.05 to 4.29, which are above the acceptance benchmark of 2.50. These findings indicate that strengthening staff competence, institutional policies, and technological support can contribute to safer and more effective drug administration to children.

CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

This chapter covers the following outline:

5.1 Key Findings

5.2 Implication of the Findings to Nursing

5.4 Summary of the Study

5.3 Limitations of the Study

5.4 Conclusion

5.5 Recommendations

5.6 Suggestion for Further Studies

UPLOADED BY MIRACLE