The Development and Evaluation of a Participatory Medication Administration Model for Registered Nurses to Prevent Medication Errors in the Pediatric Intensive Care Unit at Songklanagarind Hospital

Abstract

Background and Objectives Medication error is a critical patient-safety issue, and pediatric patients face significantly higher risk than adults from prescription, dosage-calculation, and administration errors. Despite existing medication safety measures, errors continued to occur, highlighting a gap that active nurse participation may help address. This research aimed to develop
a participatory medication administration model involving professional nurses in the Pediatric Intensive Care Unit (PICU) of Songklanagarind Hospital and examine its effects on practice, knowledge, satisfaction, and medication error incidence, including pre-post comparisons of knowledge and satisfaction.

Methods This R&D study was conducted in four phases: 1) problem identification, 2) evidence retrieval and development of the practice guideline, 3) implementation of the guideline in clinical practice, and 4) evaluation of its implementation outcomes, with 33 registered nurses in the PICU. Data were collected using five researcher-developed tools, a demographic questionnaire, observation checklist, knowledge test, satisfaction survey, and a medication error reporting record form. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. Mean differences in knowledge and satisfaction scores were analyzed using the paired t-test, with the statistical significance level set at .01

Results showed that after implementing the participatory model, nurses' knowledge and satisfaction increased significantly (p < .01), both overall and across domains, including general medication knowledge, pre-administration assessment, and medication administration practices. Compliance with the unit's medication administration standards also increased across most practice items, and a reduction was observed in the number of reported medication errors after implementation.

Conclusions and Recommendations This study suggests that a participatory approach emphasizing shared thinking, decision – making, and practice may enhance nurses' knowledge and compliance with medication administration standards and may be accompanied by a reduction in the number of reported medication errors. Given the single-setting, uncontrolled design, further adaptation and evaluation of the Model in other clinical settings are recommended before wider implementation.