Pediatric High-Alert Medications: Evidenced-Based Safe Practices for Nursing Professionals

Abstract

Jill Duncan, Jason Corcoran. Marblehead, MA: HCPro, Inc; 2007. Softcover, 168 pages. ISBN: 978-1-60146-027-1In Pediatric High-Alert Medications, Duncan and Corcoran provide evidenced-based guidelines to assist staff nurses in safely administering high-risk medications to pediatric patients. The book contains an introductory chapter followed by 11 chapters that address the unique needs of pediatric patients, general medication safety principles, and 7 specific high-alert medication classifications. Topics within the medication classification chapters focus on pharmacology concepts, pediatric considerations, medications, and nursing implications. Each chapter is highlighted by case studies that illustrate errors but, more importantly, facilitate the readers to critically think and adapt practice by learning from others’ mistakes.Drug-specific pediatric dosing is not discussed in the book because the authors chose to focus on patient safety. An added bonus to the book is a nursing education instructional guide that provides the book’s objectives and an assessment tool.The book recognizes that pediatric patients are not just small adults. Special considerations must be reviewed when delivering pharmaceutical care to this health care population to ensure patient safety. Key pediatric differences such as size, pharmokinetics, and safety principles are illustrated in the first 2 chapters. Improving pediatric high-alert medication safety through technological advances is clearly described within a separate chapter. Pharmacy preparation, clinical practice using developmentally and child-friendly methods for medication administration, and “keep kids safe” sections are presented within the book. “Keep kids safe” sections help the clinician to learn key concepts about safety standards by providing pertinent clinical information connecting medication administration and safety.The remaining 7 chapters include specific classifications such as anticoagulation therapies; chemotherapy agents; electrolyte, cardiovascular, insulin, and dextrose solutions; neuro-muscular blocking agents; and pain and sedation medications. Each classification chapter contains rationales that describe why a particular medication falls under the pediatric high-alert medication classifications, commonly used medications, and error prevention guidelines.The target audience of Pediatric High-Alert Medications include chief nursing officers, directors of nursing, nurse managers, staff educators, and staff nurses, and each chapter’s content ranges from basic to advanced knowledge depending on the experience level of the nurse. This range is demonstrated in the first 2 chapters in which content for seasoned pediatric nurses may be review materials whereas content for novice pediatric nurses may be seen as advanced knowledge.The book’s strengths include importance of medication administration safety by clinicians, case studies within each chapter, guidelines for the clinician to educate the patient and family, and a valuable reference for the Joint Commission’s National Patient Safety Goals. Various formatting methods, such as different fonts, bullets, and tables, offer a greater ease for navigating through the book. One of the drawbacks of the book is the bibliography, which contains some references greater than 5 years old. Overall, the authors have compiled a comprehensive and practical resource for nurses who are interested in achieving optimal patient safety when administering high-alert medications to pediatric patients.