Safe Drug Administration in Pediatric Nursing Education: A Quasi- Experimental Design Study

Introduction: Medication process is a complex process and errors are possible at several aspects of medication process. The present study was conducted in Neonatal Intensive Care Unit (NICU) of selected hospital, Delhi, with the objectives of investigating the incidence of medication errors in the NICU, to explore the types of medication errors occurring frequently, to develop and evaluate the training program on safe administration of pediatric drugs in terms of knowledge and skills for the nurses working in the neonatal unit. Methodology: Research approach selected for the study was quantitative approach with pre-experimental one group pre-test, post-test design. 50 prescriptions and 138 drugs were selected for investigating the medication errors and total enumeration sampling technique was used for selecting the staff nurses for evaluating the knowledge and practice of 30 staff nurses. Tools developed and used for data collection were structured knowledge questionnaire and observation check list to assess the knowledge and practice of staff nurses on safe administration of pediatric drugs respectively. Result: Medication errors were present in 127 (92.02%) drugs prescribed by the pediatrician. Medication error rate was highest during drug administration process that is 117 (94.90%) followed by the documentation error of 110 (79.7%) whereas transcription errors accounted for 69 (50%) in overall process of the medication. The prescription errors were noted in 56 (40.50%) of drug prescriptions. The mean post- test knowledge and practice scores of the staff nurses on safe administration of drugs were statistically higher at 0.05 level of significance than the corresponding mean pre-test knowledge and practice scores. Conclusion: The training program on safe administration of pediatric drugs was found to be effective in improving knowledge and practice of staff nurses.

Introduction: The administration of chemotherapeutic drugs requires specialized knowledge and skills to ensure optimal patient outcomes and minimize risks. While global guidelines emphasize the importance of safe chemotherapy administration, there is a lack of context-specific data on the knowledge and practices of nurses in tertiary health facilities in Benin City. This study addresses the gap by providing empirical evidence on their competencies and challenges. Hence this study aimed to assess the knowledge and practices of safe handling and administration of chemotherapeutic drugs amongst tertiary health facility, Benin City. Methods: The study adopted a descriptive cross-sectional study design among randomly selected 278 nurse working in the selected hospital. A researcher developed structured validated questionnaire was used as instrument of data collection. Data collected was analyse using descriptive statistics while hypothesis tested using multiple logistic regression at 5% level of significant. Data analysis was done using the IBM Statistical Package for Social Sciences (SPSS) version 28.0 for windows. Results: Overall 17% of participants had poor knowledge, and 63% had fair knowledge. More than half (51%) exhibited poor practice. Most significant factors supporting the safe handling and administration of chemotherapeutic drugs are Training and Certification (3.94), Incident Encounters (3.73), Protocol Adherence (2.93), and Utilization of PPE (2.82). Being married: (OR = 1.136 (95% C.I: 1.10–3.83, p = 0.7369), Female (OR = 4.90, 95% CI: 0.23–3.54, p = 0.479), 18–34 years (OR = 7.03, 95% CI: 0.06–8.28, p = 0.298) , Bachelor Degree (OR = 7.69, 95% CI: 0.05–7.10, p = 0.174) have higher odds of exhibiting a higher level of practice compared to other categories but not statistically significant. Conclusions: The study found that nurses have moderate knowledge and practice levels in handling chemotherapeutic drugs but still face significant gaps. It highlights the need for targeted interventions, in-service education, and institutional policies to improve competency and ensure safe chemotherapy administration.

A Bayesian three‐level meta‐analysis was conducted to examine the effectiveness of Augmented Reality (AR) based interventions in enhancing the domain‐specific skills of individuals with autism spectrum disorder (ASD) and/or intellectual and developmental disabilities (IDD). Five moderators, age, gender, disorder type, AR content and skill domains, were further tested to explore the sources of heterogeneity in intervention effectiveness. A total of 28 single‐case experimental design studies with 104 individuals were included in the meta‐analysis. The results indicate that AR‐based interventions have a positive immediate effect on improving skills and that the intervention becomes increasingly effective over time. Although no strong evidence was found for the five moderators examined, patterns emerged indicating that AR interventions had the greatest immediate impact on vocational skills, followed by improvements in physical, living, academic and social skills. Additionally, females and individuals with ASD appeared to benefit more from these interventions. Overall, this study sheds light on the overall AR‐based interventions for individuals with ASD/IDD, as well as the potential moderator effects that contribute to the heterogeneity in intervention effectiveness. Practitioner notes What is already known about this topic AR‐based intervention is generally effective in improving skills among individuals with special needs, including people with ASD and/or IDD. The effectiveness of the AR‐based intervention varies between individuals; the differences might be due to factors such as individual characters, skill domains, etc. What this paper adds This meta‐analysis includes data from 28 single‐case experimental design (SCED) studies, which is more than any previous SCED meta‐analyses on the topic. This meta‐analysis examined the effectiveness of AR‐based interventions in two different aspects: (1) the immediate effect at the start of the intervention and (2) whether the intervention becomes increasingly effective over time. This meta‐analysis examined both individual‐level factors (ie, age, gender, disorder type) and study‐level factors (ie, AR content type and skill domains) that may contribute to differences in intervention effectiveness across individuals and studies. Implications for practice When appropriately designed, AR‐based interventions can lead to rapid skill improvements for individuals with ASD and/or IDD. Continued intervention is likely to result in sustained improvement. When incorporating advanced technologies like AR into instructional designs, educators should be mindful of potential factors that may affect the intervention's effectiveness, such as gender and skill domains.

The use of dragon fruit stems as food is still very limited. The development of dragon fruit stems needs to be done by utilizing existing technology, namely by making it into dragon fruit stem flour. This study aims to determine the effect of temperature and drying time on the physical and chemical properties of pitaya stem flour. The experimental design in this study consisted of two factors, namely drying temperature (S Factors) covering S1 (45oC), S2 (55oC), S3 (65oC) and a drying time (L factors) consisting of L1 (18 hours), L2 (21 hours) and L3 (24 hours). The experimental design in the main study used a randomized block design with a 3 x 3 factorial pattern, which was repeated 3 times. The result obtained from this study show that drying temperature and drying time significantly affect the moisture content, ash content, vitamin C, water absorption, fineness modulus, and average diameter of the particles. The interaction of temperature and drying time had a significant effect on moisture content, ash content, vitamin C, color, water absorption, fineness modulus and average diameter but did not affect the yield of pitaya stem flour.

Experimental design and statistical analyses of fish growth studies

Aim of the study : This study aimed to determine obstacles' and facilitators facing safe administration of chemotherapy by oncology nursing staff .  Material and methods : Study design: descriptive study design (qualitative) was used . Setting: the study was conducted at Tanta cancer center affiliated to Ministry of Health at El Garbeia Governorate Egypt. Sample: All (55) nurses working in oncology medical department at Tanta cancer center and administer chemotherapy. Tools: five tools  was used to conduct this study . Tool one :  Structured interview questionnaire: It was developed by the research after review of related literature. It was consisted of two parts : First part: Socio-demographic characteristics of oncology nurses and Second part: Level of knowledge needed about cytotoxic chemotherapy) by nurses .The total responses was summed up and classified into three levels,  high ,moderate &Low .  Tool Two Obstacles' facing nurses for safe administration of hazardous drug. It was developed by the researchers in Arabic & consisted of 13 open ended questions.Tool Three: : Modified Nurses attitude toward safe administration of hazardous drug for cancer patients (chemotherapy) questionnaire . It was adapted and translated into Arabic by the researchers. It was consisted of 18 items & included both positive and negative item statements  Tool Four: Modified Nurses anxiety and fear to administer hazardous drug for cancer patient questionnaires.It was adapted and translated into Arabic by the researchers. It consists of 18 items, the responses were 4 response Statements .Total anxiety scores: divided into three levels high , moderate and low according to scores ..Tool Five : Facilitators' of safe administration of hazardous drugs (cytotoxic chemotherapy : It was developed by the researchers in Arabic after review of related literature. It consisted of 13 open ended questions.Method : 1. Permission was obtained from head of oncology department at main Tanta University Hospital .2. Ten experts in the field of oncology, five oncology experts affiliated to Faculty of Medicine Tanta University and five nurses revised the tool for content validity. 3. Each nurses interviewed individually and participated to fulfill the questions in the five tools. 4. Ethical considerations: Consent was obtained from nurses after explanation of the research study aims and content. Confidentiality of data was ensured using code number instead of their names and withdrawal from the study was reserved. 5. Pilot study was carried out on 10% of the study sample 10 nurses  working in outpatient clinics and administer chemotherapy and not included in the sample to test tool feasibility and applicability and the required modification was done.  Results :Oncology nurses age was from 21-55 and have years of experiences from 0-30 year and more than two third of them married with deplume of secondary school level of education with no training courses about safe chemotherapy administration. Obstacles' for safe chemotherapy administration as perceived by nurses working in oncology department and administer chemotherapy according to priority ranking related to patient and as well as nurses were the first priority  while the last priority was related to hospital system of care delivery. Nurses attitude affect their behaviors to administer chemotherapy safely since slightly more than half 52% of nurses working in oncology had positive attitude toward safe administration of chemotherapy needed high level of knowledge and more than two third 76.36 % had moderate level of anxiety respectively and the more oncology nurses had positive attitude and more than two third 70.9% expressed they are in need to increased knowledge to be at high level the more they feel higher anxiety level to administer chemotherapy safely .Also facilitators for according to priority ranking, environmental factors especially quite wide space with sufficient illumination were the first priority followed by time of the shift and the last priority facilitors was hospital system .Conclusion and Recommendation Recommendations : Strategies to improve medication safety also need to be targeted at  specific multiple points in addition to oncology nurses attitudes and feelings toward safe chemotherapy administration which in respect shaping their behavior of cancer patients' care.

AimsTo examine the association between nurse skill mix (the proportion of total hours provided by Registered Nurses) and patient outcomes in acute care hospitals.DesignA quantitative systematic review included studies published in English between January 2000 – September 2018.Data sourcesCochrane Library, CINAHL Plus with Full Text, MEDLINE, Scopus, Web of Science and Joanna Briggs Institute were searched. Observational and experimental study designs were included. Mix‐methods designs were included if the quantitative component met the criteria.Review methodsThe Systematic Review guidelines of the Joanna Briggs Institute and its critical appraisal instrument were used. An inverse association was determined when seventy‐five percent or more of studies with significant results found this association.ResultsSixty‐three articles were included. Twelve patient outcomes were inversely associated with nursing skill mix (i.e., higher nursing skill mix was significantly associated with improved patient outcomes). These were length of stay; ulcer, gastritis and upper gastrointestinal bleeds; acute myocardial infarction; restraint use; failure‐to‐rescue; pneumonia; sepsis; urinary tract infection; mortality/30‐day mortality; pressure injury; infections and shock/cardiac arrest/heart failure.ConclusionNursing skill mix affected 12 patient outcomes. However, further investigation using experimental or longitudinal study designs are required to establish causal relationships. Consensus on the definition of skill mix is required to enable more robust evaluation of the impact of changes in skill mix on patient outcomes.ImpactSkill mix is perhaps more important than the number of nurses in reducing adverse patient outcomes such as mortality and failure to rescue, albeit the optimal staffing profile remains elusive in workforce planning.

Anticoagulants have been demonstrated to reduce tumor growth in certain experimental animal systems. Inhibition of clot formation interferes with tumor growth and spread while enhancement of coagulation promotes tumor growth and spread. The fact that the coagulation mechanism is commonly activated in human malignancy together with preliminary reports of therapeutic efficacy of anticoagulants suggests that the coagulation mechanism may be of pathophysiologic significance also in the growth of human tumors. A VA Cooperative Study has been established to test the hypothesis that warfarin anticoagulation will modify the course of malignancy in man. The purpose of this paper is to present the rationale and experimental design for this study with emphasis on management of anticoagulant administration in cancer patients. This paper serves as the basis for forthcoming reports of toxicity and therapeutic efficacy of warfarin in human malignancy.

Design enumeration and isomorphism examination are two difficult tasks in the study of experimental design. The two tasks are different but often related to each other. Design enumeration is concerned with the complete generation of certain types of designs, such as regular designs or orthogonal arrays. Isomorphism examination, on the other hand, compares whether two designs have the same structure subject to some row and column operations. During the process of design enumeration, it is often required to perform isomorphism examination at some stage to reduce the possible redundant calculation. This dissertation includes two main parts. In the first part, we propose an assembly method based on the indicator function and the projection to enumerate all non-isomorphic two-level designs. The assembly method allows us to generate all designs sequentially in a hierarchical structure. We present an algorithm based on the assembly method and generate a complete catalogue of non-isomorphic designs for some cases. In the second part, we develop an initial screening method based on the counting vector for isomorphism examination. We prove that the method provides a more efficient examination than some methods proposed in other articles. The technique of projection is also applied to improve the examination efficiency.

Safety maintenance and prevention of damage to patients caused by errors in nursing have a special importance, and a lack of sufficient attention to the correct principles of drug administration can lead to the patient' health threats and reducing safety.The administration of drugs is complex and influenced by many factors, particularly in pediatric wards; thus, the present study aimed to explain pediatric nurses' experiences on obstacles to safe drug administration. In this study, the qualitative approach and content analysis method were used. Twenty pediatric nurses involved in medication administration were selected for participation using purposive sampling. Data was collected through semi-structured interviews. Using continuous analysis, data collection and comparison were performed at the same time. From the data analysis, 4 main themes were extracted. Working pressure, lack of drug resources, insufficient colleague performance, and lack of experience and knowledge in drug administration were four main themes obtained from study. Care managers can identify obstacles to safe medication administration to improve patient safety. For which necessary measures must be taken to remove them and to enhance patient safe care provided by nurses.

Nurses are responsible for medication administration, and, as with many other nursing interventions, some risk is involved. If an error occurs, a patient may suffer harm or injury, which may lead to a permanent disability or a fatality. To ensure safe drug administration, nurses are encouraged to follow the five rights (‘R's; patient, drug, route, time and dose) of medication administration to prevent errors in administration. The five ‘R's do not consider all causes of drug errors; instead, they focus on medication administration at the bedside so they relate only to this stage of a drug prescription. A drug's journey is more than what happens at the bedside; therefore, the reduction of errors requires more than just the five ‘R's. This article proposes a multi-professional, evidence-based approach to medicines management, which all clinicians can work towards, together. Clinicians can achieve this approach by considering the National Patients Safety Agency's definition of a medication error and the values set out by the National Prescribing Centre. The approach utilizes 10 ‘R's, which provide a benchmark for good practice. The 10 ‘Rs’ advocate the need for the knowledge of the causes of drug errors, how to implement strategies to reduce drug errors, how to ensure safe practice throughout the medication journey, from chemical preparation, to monitoring outcomes, to response.

Inactivity and less varied learning model of science used by teachers in Tegal Region causes students to understand less about the concept of science lesson. This research aims to determine (1) the difference in the increase of science literacy skills of junior high school students in Tegal District between using the conceptual learning model with the lecture model, (2) the students' literacy ability profile. Experimental design study with pretest-posttest control group design. The sample of this research use the students of class VIII SMP X Slawi, SMP Y Dukuhwaru and MTs Z. Each school is randomly selected two classes, as experiment class and control class. The variables measured are the improvement of science literacy ability, the availability of science as the body of knowledge, science as a way of thinking, science as the process of investigation and interaction of science, technology and society. Wake up is the improvement of literacy ability of science with CUPs better than lecture method. The profile of each school increases as follows: SMP Negeri X Slawi has an added value of 0.12 SMP Negeri Y Dukuhwaru 0.36 and MTs Z 0.07. The high-down science literacy enhancement profile is as follows: Interaction of science, technology and society, science as a body of knowledge, science as a process of investigation, and science as a way of thinking. The results of this study show that the conceptual learning model Conceptual Procedure (CUPs) can effectively improve the science literacy ability of middle school students with medium and high category in Tegal regency. Less effective for low category SMP.

We undertook a randomised control led trial to evaluate the effect of a prototype device which attaches to the intravenous drug administration port, and allows injection of intravenous drugs only after the user scans the barcode on the syringe label. This requires two steps: first, that the correct drug label is generated; and second, that the syringe-with-label is scanned before administration. Ten anaesthetists, who were unaware of the primary outcome being measured, administered general anaesthesia for two simulated standardised cases each without and with our prototype (control and intervention, respectively). The primary outcome measured was compliance with a safe drug administration procedure (defined as a two-step procedure where, step one is scanning a drug ampoule to print a label for a syringe and step two is scanning of the labelled syringe before administering it intravenously). A total of 182 intravenous drug administrations occurred in the study (91 in each group). We found that the use of our prototype increased safe drug administration behaviour in experienced anaesthetists; 33 (36.3% [95% CI 26-47%]) vs. 91 (100% [95% CI 96-100%]) in the control and intervention groups, respectively (p = 0.0001).

Background and importanceOcrelizumab is the first drug approved in Europe for the treatment of primary progressive multiple sclerosis (PPMS). It is an anti-CD20 monoclonal antibody whose use has also been...

Safe drug administration in pediatric nursing is a critical aspect of patient care, requiring precise calculations, in-depth pharmacological knowledge, and a patient-centered approach. Children have unique physiological characteristics that influence drug absorption, distribution, metabolism, and excretion, making medication safety a top priority. This article explores the principles of pediatric pharmacology, discusses the challenges nurses face in administering medications to children, and outlines best practices to enhance safety, including proper dosage calculations, understanding pediatric drug interactions, and implementing strategies to reduce medication errors. By following evidence-based guidelines, pediatric nurses can optimize drug therapy outcomes and ensure safe medication administration in children.