Role of the nurses in partnering with mothers to give oral medication to their hospitalised child: Modification and development of a contextualised evidence-based practice guideline.

Nadia Harris,Natasha North,Andrea Amos

doi:10.4102/curationis.v44i1.2224

Abstract

BackgroundIn paediatric wards, children are often reluctant to receive medication from nurses and eventually it is given by the parents. It is a common practice for nurses to hand the medication to mothers to give to their children, However, it is an ‘informal’ practice and lacks evidence-based guidelines.ObjectivesTo develop a contextualised and adapted evidence-based guideline to support nurses to partner with mothers/carers so that they can safely give oral medication to their hospitalised child under the supervision of a competent nurse.MethodExisting relevant guidelines were identified through searches of bibliographic databases and websites. The AGREE II: Appraisal of Guidelines for Research and Evaluation II instrument was used to appraise the quality of the identified sources. The process of guideline adaptation recommended by the South African Guidelines Excellence project was followed, and a list of adapted recommendations was developed, aligned with the legislative and regulatory frameworks for nursing in South Africa. Accessible end user documentation was developed.ResultsSix sources were screened and three sources were found to be eligible and were subjected to full appraisal. Two guidelines and one policy document were identified as suitable for adaptation. Expert consultation confirmed that the resulting adapted guideline was sound, easy to understand, and well presented for the target audience.ConclusionThis process successfully led to the development of a modified evidence-based practice guideline to enable nurses to partner with mothers/caregivers in safely giving oral medication to their hospitalised child in lower-resourced African settings.

Highlights

Medication errors are one of the most frequent causes of adverse events in the hospital setting and children are believed to be at a higher risk of harm from such errors (Maaskant et al 2015)
A systematic review of publications related to adverse drug events in 18 African hospitals reported higher rates of medication errors than hospitals from developed countries, reports were variable and inconsistent (Mekonnen et al 2018)
Our contextualised and adapted evidence-based guideline is intended to enable nurses to partner with mothers or carers to be competent and safely give oral medication to their hospitalised child under the supervision of a competent nurse in South African settings

Summary

Introduction

Medication errors are one of the most frequent causes of adverse events in the hospital setting and children are believed to be at a higher risk of harm from such errors (Maaskant et al 2015). A systematic review of studies related to medication errors in children worldwide found that the most common type of medication error was dosing error (Ghaleb et al 2006). A systematic review of publications related to adverse drug events in 18 African hospitals (of which six studies were from South Africa) reported higher rates of medication errors than hospitals from developed countries, reports were variable and inconsistent (Mekonnen et al 2018). Reported rates of medication errors in African settings vary considerably, but appear to be higher in paediatric care settings than for adult patients (Mekonnen et al 2018), possibly because of the added complexity of dosing. It is a common practice for nurses to hand the medication to mothers to give to their children, it is an ‘informal’ practice and lacks evidence-based guidelines

Objectives

Methods

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Discussion

Conclusion