Administration Errors Research Articles

How Common are the Errors in Insulin Injection Techniques – A Real World Study

Background: Insulin therapy is identified as the cornerstone of diabetes management for more than a century. Even though awareness programs on correct insulin administration have occupied the mainstream of diabetes management interventions, the prevalence of insulin injection errors among people with diabetes is significant in its count. Aims and Objectives: The current study evaluates the prevalence of various insulin injection errors among people with type 2 diabetes. Materials and Methods: The study employed a survey-based cross-sectional design to analyze the prevalence of insulin injection errors. The data was collected from people with T2D visiting the Outpatient Department (OPD) of four comprehensive diabetes research centres in Kerala, India. The inclusion criteria for the study include people with type 2 diabetes. The exclusion criteria included people with other types of diabetes, people with newly diagnosed T2D, and people with T2D who were insulin pump users. Demographic characteristics of the cohort were determined. The common errors in the injection administration were identified and the frequency of each error was determined. Data for the variables including, site selection, cleaning of needle and lipohypertrophy were collected. The categorical variables considered for the study was summarized as frequency (%) and all the continuous variables were presented as mean (SD) or median (Q1, Q3) based on the normality assumption. All the tests were carried out at a level of significance of 5 % using R version 4.2.3. Results: The common errors identified among the study cohort include incorrect site selection, inappropriate storage temperature, cleaning of the needle with spirit, hypoglycemia due to incorrect administration of insulin, and the presence of lipohypertrophy. Conclusion: The findings from the study underline the varied types of errors in the self-administration of insulin among the different age groups of the diabetes population and urge the health-care professionals to impart continuous review of the injection procedures patients follow while taking insulin injections

Sustaining a culture of safety and optimising patient outcomes while implementing zero harm programme: a 2-year project of the nursing services – SBAHC

This quality improvement report details how Sultan Bin Abdulaziz Humanitarian City (The City), the largest rehabilitation facility within Middle East with a capacity of 511 beds and more than 20...

Safety profile and signal detection of phosphodiesterase type 5 inhibitors for erectile dysfunction: a Food and Drug Administration Adverse Event Reporting System analysis.

Phosphodiesterase type 5 inhibitors (PDE5Is) are generally well tolerated but have been associated with uncommon and significant adverse events (AEs). This study aims to investigate and compare the characteristics of AEs associated with PDE5Is used for erectile dysfunction and identify any safety signals in a postmarketing surveillance database between 2010 and 2021. A descriptive analysis was conducted for all AEs reported to the Food and Drug Administration Adverse Event Reporting System for 4 PDE5Is-avanafil, sildenafil, tadalafil, and vardenafil-indicated for erectile dysfunction between January 2010 and December 2021. The frequency of the most reported AEs and outcomes were identified. A disproportionality analysis based on proportional reporting ratio (PRR) and reporting odds ratio (ROR) was conducted for the most common and clinically important AEs to identify signals to gain insights into potential differences in safety profiles. The outcome measures of the study are frequency of reported AEs and outcomes following AE. A total of 29 236 AEs were reported for PDE5Is during the study period. The most reported AE was "drug ineffective" with 7115 reports (24.3%). Eight safety signals were detected across the 4 drugs. Key signals were sexual disorders (PRR, 3.13 [95% CI, 2.69-3.65]; ROR, 3.24 [95% CI, 2.77-3.79]) and death (PRR, 3.17 [2.5-4.01]; ROR, 3.211 [2.52-4.06]) for sildenafil, priapism (PRR, 3.63 [2.11-6.24]; ROR, 3.64 [2.12-6.26]) for tadalafil, and drug administration error (PRR, 2.54 [1.84-3.52]; ROR, 2.6 [1.86-3.63]) for vardenafil. The most reported outcomes were other serious events with 6685 events (67.2%) and hospitalization with 1939 events (19.5%). The commonly reported AEs and detected signals may guide clinicians in treatment decision making for men with erectile dysfunction. This is the first comprehensive report and disproportionality analysis on all types of AEs associated with PDE5Is used for erectile dysfunction in the United States. The findings should be interpreted cautiously due to limitations in the Adverse Event Reporting System, which includes self-reports, duplicate and incomplete reports, and biases in reporting and selection. Therefore, establishing a causal relationship between the reported AEs and the use of PDE5Is is uncertain, and the data may be confounded by other medications and indications. PDE5Is demonstrate significantly increased risks of reporting certain clinically important AEs. While these events are not common, it is imperative to continually monitor PDE5I use at the levels of primary care to national surveillance to ensure safe utilization.

Interprofessional Collaboration on Drug Administration to Clients with Diabetes Mellitus at Bali Hospital: A Case Study

Background: Errors in health services in Indonesia are caused by poor communication in implementing interprofessional collaboration with a percentage of 70-80%. This causes medical errors, namely with the percentage distribution of 11% drug administration errors, 46% inappropriate drug use and 54% drug prescribing errors.The purpose of this scientific work is to analyze interprofessional collaboration on drug administration to clients with diabetes mellitus.
 Method: The method used in this study is observation and measurement tools to evaluate interprofessional collaboration using a checklistSelf-rating score for Interprofessional Collaboration in Clinical Practice.
 Results: The results obtained are that the application of interprofessional collaboration has not been carried out optimally due to a lack of communication clinical pathway as a guide in carrying out clinical actions, and no health workers have attended IPC (Inter-Professional Collaboration) implementation training.Good communication during the interprofessional collaboration process can solve health problems and improve patient safety. In addition to optimizing the implementation of interprofessional collaboration by holding integrated training to enhance good cooperative relations between professions.
 Conclusion: Therefore, there is a need for evaluation by services in hospitals regarding interprofessional collaboration as an effort to reduce the risk of errors in administering drugs to patients and improve the quality of health services in hospitals.

Identification of enteral nutrition errors in a single-center quality-improvement audit.

Enteral nutrition (EN) therapy is a multistep process including evaluation, prescription, procurement, dispensing, labeling, administration, and monitoring. EN therapy is prone to human errors, but these are poorly defined in the literature. The purpose of this study was to audit EN administration practices to quantify errors of execution and identify which components of the EN order were labeled, administered, or documented incorrectly. On 2 nonconsecutive days, we identified all hospitalized patients with active EN orders and prospectively collected the following information: EN formula hanging/documented, formula hang time, infusion rate/documented rate (continuous EN), infused volume and documented schedule (intermittent EN), and EN modular documentation. Mismatches to the EN order were considered errors. We reviewed 1 month of hospital EN-related safety events for comparison. Of 1045 data points collected from 160 patients, we identified 275 errors of execution: 135 labeling errors and 140 administration errors. The most common were hang time >48 h (85%), wrong number of modulars documented (48%), and wrong infusion rate (19%). We found one reported safety event (wrong formula delivered but not infused). We identified a 15.9% error rate in EN order execution/documentation and 14% compliance with documentation of 48-h hang time. Errors (safety events) were grossly underreported. This highlighted several areas of opportunity to improve current EN use process, consistent with previous research on EN and oral nutrition supplement administration. Based on our findings, we plan to recommend implementation of EN barcoding at our institution, to model the familiar medication administration record.

EPERCAS Study. Strategies for Preventing Medication Administration Errors in Nursing Homes.

Medication administration errors are one of the most frequent types of errors. There are different safety guides and recommendations to prevent medication errors (MEs) generally directed to the hospital environment. However, specific recommendations for the management process in the residential care environment are lacking. The main objective of this study was to develop a list of recommendations to aid in preventing the most important MEs that occur during the administration process in Nursing Homes (NH), such as not administering doses or administering medication to the wrong patient. The effectiveness and feasibility of the strategies proposed were evaluated by a panel of experts. The conventional Delphi method was applied. The first round in our study was a face-to-face questionnaire; the second round included an online questionnaire based on the results of the first round. Finally, eight strategies were included in the EPERCAS List: one professional in charge per shift; one professional commissioned by the residential unit; avoid interruptions; avoid medication outside of meal times; personalized medication drawer for each resident including oral medication from a bag and laxatives, inhalers, syrups, eye drops…; identification of the resident and their medication; visual check that everything has been administered; signature to verify medication administration. The great continual challenge for NH is to define safe and affordable procedures. Minimum safety recommendations for administering the medications, such as those included in this study, should be employed. Our next stage is to implement these strategies in one of our NH and subsequently, evaluate its effectiveness and consider expanding it to the rest of the NH.

Error traps in the perioperative management of children with type 1 diabetes.

Patients with type 1 diabetes mellitus (T1D) require insulin administration at all times to maintain euglycemia and metabolic stability. Insulin administration in the perioperative period is complicated by fasting requirements and perioperative stressors that can change the patient's insulin needs. In addition, many anesthesia providers are not familiar with insulin dosing strategies and technology, such as insulin pumps and continuous glucose monitors (CGMs), that are commonly used by patients with T1D. Errors in perioperative insulin administration can lead to hypoglycemia, hyperglycemia, and diabetic ketoacidosis. This article reviews common errors of associated with the perioperative management of patients with T1D, including failure to assess and coordinate patient care preoperatively; failure to understand diabetes management and technology; failure to monitor blood glucose and recognize dysglycemia; and failure to appropriately administer basal insulin.

What to learn from analysis of medical disputes related to medication errors in nursing care.

Nurses, who are the last safeguard against and have the final opportunity to prevent medication errors (MEs), play a vital role in patient safety by managing medications. This study described the characteristics of medical dispute cases, medication information, and stage and types of MEs in Korea. We performed a descriptive analysis of 27 medical dispute cases related to MEs in nursing care in Korea. Around 77.7% of patients suffered serious harm or died due to MEs in this study. The types of medications included anxiolytics and analgesics, and 51.9% of them were high-alert medications. Among cases of administration errors, failure to patient assessment before and after administration was the most common error followed by administering the wrong dose. Nurses should perform their duties to ensure safety and improve the quality of nursing care by monitoring patients after administering medications and should be prepared to take quick action to reduce harm.

Assessing ward system changes to mitigate medication administration errors: A comprehensive systematic review of interventional studies

Assessing ward system changes to mitigate medication administration errors: A comprehensive systematic review of interventional studies

Evaluation of intermittent antimicrobial infusion documentation practices in intensive care units: A cross-sectional study

ObjectiveTo observe nurse administration of carbapenem antibiotics, in the context of medication safety measures, in intensive care units. Research Methodology/DesignA quantitative study was conducted using observation principles. SettingThree adult private and public Intensive Care Units in the health district of a capital city in KwaZulu-Natal, South Africa. Main Outcome MeasuresNurse practices were observed for double-checking of the medication order, medication vial, and method of preparation and administration. Infusion bags were inspected for nurse labelling of medication and patient details. Patient medication treatment charts were inspected for nurse signature. ResultsCarbapenem infusion administrations (n = 223) to twenty patients were observed. Adherence to the scheduled time occurred in 34.9% administrations, 5.4% doses were not given, and an incorrect dose given on 1.4% administrations. One hundred and forty-four (64.6%) infusion bags were inspected during the administrations: there was no medication label affixed to 21.5% bags, and only 8.3% of bags were labelled with essential details; the patient’s name, drug, dose, date, time, signature of the nurse mixing and administering the dose, and signature of the secondary nurse. ConclusionThere was a lack of compliance with accepted medication risk mitigation measures. Sub-optimal double-checking resulted in the incorrect dose given, missed dose, and non-adherence to scheduled administration time. This has implications for the optimal administration of antimicrobial medications, raising concerns about the efficacy of treatment for critically ill patients. Implications for Clinical PracticeParenteral administration errors pose a challenge in acute care areas. Risk mitigation measures include double-checking of medications. If antimicrobial treatment is not administered at the prescribed dosing intervals, this may have implications for the efficacy of time-dependent broad-spectrum antibiotics such as carbapenems. Medication administration errors involving antimicrobial medications should therefore be considered as high-risk errors, with the potential to contribute towards antimicrobial resistance.

Implementing Strategies to Prevent Home Medication Administration Errors in Children With Medical Complexity.

Implementing Strategies to Prevent Home Medication Administration Errors in Children With Medical Complexity.

Oral medicine administration errors in a patient with an enteral feeding tube

Proper nutrition is vital for all patients with an expected lifespan. It is strongly recommended that patients whose oral intake is impaired or suspected to be impaired should be provided nutritional support. Concurrent medication administration during enteral nutrition may result in complications unless necessary precautions are taken. This study presents a case of a 94-year-old male patient with poor general health condition and being treated in a palliative care service. The patient was fed with an enteral feeding tube for seven drugs. There have been two tube occlusions causing the replacement of the tube since the enteral feeding tube was placed.The clinical pharmacist checked how the patient’s drugs were given through a nasogastric tube and how the patient’s relatives administered the drugs. Inappropriate dosage form selections and errors in administration through the nasogastric tube were identified. The interaction and incompatibility of the patient’s medications with the nutritional formula were also investigated. The clinical pharmacist informed the person giving the medicine to the patient about the correct administration of the medicine from the tube. The proper method for administering medications from the tube was ensured accordingly. Following the clinical pharmacist’s training, it was observed that the nasogastric tube was correctly used to administer the drug and the patient being monitored had no tube obstruction in the later phases of the treatment.It may be beneficial for a pharmacist to review drug dosage forms and applications in patients with a feeding tube in order to ensure correct administration and avoid undesired drug interactions.

Barriers and enablers for safe medication administration in adult and neonatal intensive care units mapped to the behaviour change wheel.

Intensive care settings have high rates of medication administration errors. Medications are often administered by nurses and midwives using a specified process (the '5 rights'). Understanding where medication errors occur, the contributing factors and how best practice is delivered may assist in developing interventions to improve medication safety. To identify medication administration errors and context specific barriers and enablers for best practice in an adult and a neonatal intensive care unit. Secondary aims were to identify intervention functions (through the Behaviour Change Wheel). A dual methods exploratory descriptive study was conducted (May to June 2021) in a mixed 56-bedded adult intensive care unit and a 6-bedded neonatal intensive care unit in Sydney, Australia. Incident monitoring data were examined. Direct semi-covert observational medication administration audits using the 5 rights (n = 39) were conducted. Brief interviews with patients, parents and nurses were conducted. Data were mapped to the Behaviour Change Wheel. No medication administration incidents were recorded. Audits (n = 3) for the neonatal intensive care unit revealed no areas for improvement. Adult intensive care unit nurses (n = 36) performed checks for the right medication 35 times (97%) and patient identity 25 times (69%). Sixteen administrations (44%) were interrupted. Four themes were synthesized from the interview data: Trust in the nursing profession; Availability of policies and procedures; Adherence to the '5 rights' and departmental culture; and Adequate staffing. The interventional functions most likely to bring about behaviour change were environmental restructuring, enablement, restrictions, education, persuasion and modelling. This study reveals insights about the medication administration practices of nurses in intensive care. Although there were areas for improvement there was widespread awareness among nurses regarding their responsibilities to safely administer medications. Interview data indicated high levels of trust among patients and parents in the nurses. This novel study indicated that nurses in intensive care are aware of their responsibilities to safely administer medications. Mapping of contextual data to the Behaviour Change Wheel resulted in the identification of Intervention functions most likely to change medication administration practices in the adult intensive care setting that is environmental restructuring, enablement, restrictions, education, persuasion and modelling.

Prescription de demi-doses en établissement d’hébergement pour personnes âgées dépendantes : apport d’un automate de préparation de doses à administrer

The territorial pharmacy of the West of Paris carries out an automated dose dispensing for a nursing home. The machine overpacks dry oral forms in unit doses and dispenses them in named pillboxes. Tablets prescribed in fractions are currently dispensed in whole unit doses, fractioned in advance by a nurse, then administered by a caregiver. These operations present a number of risks, including a break in dose identification right through to administration. The objective was therefore to extend the automated dose dispensing to split tablets by repackaging. The development of this new process, its software qualification and its evaluation after six months of routine use are described. This process is composed of three steps, secured by pharmaceutical controls: manual production of fractions in the preparatory area, automated repackaging using a barrel and automated dispensing in pillboxes. In total, 2000fractions were produced in six months with a non-compliance rate lower than 5% and a negligible financial loss. Following the assumption of this activity by the pharmacy, the care team declares themselves satisfied by the gain in time and safety. Automated dispensing of unit doses in fractions ensures identification of the dose from prescription to administration, thus limiting administration errors.

Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review.

Most antimicrobial drugs need an intravenous (IV) administration to achieve maximum efficacy against target pathogens. IV administration is related to complications, such as tissue infiltration and thrombo-phlebitis. This systematic review aims to provide practical recommendations about diluent, pH, osmolarity, dosage, infusion rate, vesicant properties, and phlebitis rate of the most commonly used antimicrobial drugs evaluated in randomized controlled studies (RCT) till 31 March 2023. The authors searched for available IV antimicrobial drugs in RCT in PUBMED EMBASE®, EBSCO® CINAHL®, and the Cochrane Controlled Clinical trials. Drugs' chemical features were searched online, in drug data sheets, and in scientific papers, establishing that the drugs with a pH of <5 or >9, osmolarity >600 mOsm/L, high incidence of phlebitis reported in the literature, and vesicant drugs need the adoption of utmost caution during administration. We evaluated 931 papers; 232 studies were included. A total of 82 antimicrobials were identified. Regarding antibiotics, 37 reach the "caution" criterion, as well as seven antivirals, 10 antifungals, and three antiprotozoals. In this subgroup of antimicrobials, the correct vascular access device (VAD) selection is essential to avoid complications due to the administration through a peripheral vein. Knowing the physicochemical characteristics of antimicrobials is crucial to improve the patient's safety significantly, thus avoiding administration errors and local side effects.

Feline Injection-Site Sarcoma and Other Adverse Reactions to Vaccination in Cats.

Vaccine-associated adverse events (VAAEs), including feline injection-site sarcomas (FISSs), occur only rarely but can be severe. Understanding potential VAAEs is an important part of informed owner consent for vaccination. In this review, the European Advisory Board on Cat Diseases (ABCD), a scientifically independent board of feline medicine experts, presents the current knowledge on VAAEs in cats, summarizing the literature and filling the gaps where scientific studies are missing with expert opinion to assist veterinarians in adopting the best vaccination practice. VAAEs are caused by an aberrant innate or adaptive immune reaction, excessive local reactions at the inoculation site, an error in administration, or failure in the manufacturing process. FISS, the most severe VAAE, can develop after vaccinations or injection of other substances. Although the most widely accepted hypothesis is that chronic inflammation triggers malignant transformation, the pathogenesis of FISS is not yet fully understood. No injectable vaccine is risk-free, and therefore, vaccination should be performed as often as necessary, but as infrequently as possible. Vaccines should be brought to room temperature prior to administration and injected at sites in which FISS surgery would likely be curative; the interscapular region should be avoided. Post-vaccinal monitoring is essential.

Evaluation of medication errors in patients with kidney diseases in Quetta, Pakistan.

Medication errors represent a significant challenge in healthcare, as they can lead to enduring harm for patients and impose substantial financial burdens on the healthcare system. To effectively mitigate medication errors, it is imperative to gain a comprehensive understanding of their frequency and the contributing variables. Thus, the primary objective of this study was to evaluate the occurrence of medication errors among patients with kidney diseases in Quetta, Pakistan. The objective of this study was to assess medication errors in patients diagnosed with kidney diseases in Quetta, Pakistan. The research was conducted at the Balochistan Institute of Nephro-Urology Quetta (BINUQ) Hospital, which serves as a tertiary care center specializing in the treatment of kidney diseases. A cross-sectional descriptive study design was employed over a period of six months. The study population consisted of patients admitted to the Nephro-urology wards at BINUQ Hospital during the specified duration. Data collection encompassed various methodologies, including checklist-guided observation, review of prescription order forms, documentation of drug administration, and comprehensive analysis of patient medical records. Descriptive and analytical analyses were conducted using SPSS version 23. Univariate analysis was employed to identify independent variables associated with medication errors, employing a significance level of p<0.01. The multivariate logistic regression analysis incorporated variables that exhibited a significant association with medication errors during the univariate analysis. Only those variables demonstrating a p-value of less than 0.05 at a 95% confidence level were considered significant predictors of medication administration errors within the final multivariate model. Among the 274 medication errors identified in the study, documentation errors accounted for 118 cases (12.06%), administration errors for 97 cases (9.91%), prescribing errors for 34 cases (3.47%), and dispensing errors for 25 cases (2.55%). Statistical analysis revealed significant associations (p<0.05) between forgetfulness and duty shift, and medication errors in the documentation process. Similarly, inattention was significantly associated (p<0.05) with both prescribing and dispensing errors. Furthermore, the number of medications received emerged as the most influential factor associated with medication errors. Patients receiving 4-6 medications exhibited an odds ratio of 9.08 (p<0.001) compared to patients receiving 1-3 medications, while patients receiving more than 6 medications had an odds ratio of 4.23 (p<0.001) in relation to patients receiving 1-3 medications. In conclusion, this study determined that documentation errors were the most prevalent medication errors observed in patients with kidney disease in Quetta, Pakistan. Forgetfulness and duty shift were associated with documentation errors, whereas inattention was linked to prescribing and dispensing errors. The significant risk factor for medication errors was found to be a high number of prescribed medications. Therefore, strategies aimed at reducing medication errors should prioritize enhancements in documentation practices, alleviating medication burden, and increasing awareness among healthcare providers.

Nursing Practice Improvement Strategies for Reducing Medication Errors

The safety of the patient is put at risk by medication mistakes, particularly during administration. In order to achieve Joint Commission International (JCI) certification, a Chinese hospital undertook research to lower medication errors (MEs). Comprehensive interventions were carried out, and the number of MEs fell by 58,3 % between the first half of 2016 and the first half of 2018. During the same time frame, there was a 55,6 % drop in high-alert drug mistakes. The majority of mistakes were omissions, which decreased by 50 %. Errors in intravenous administration also declined. Nurses with more experience made fewer mistakes, and surgical wards had twice as many mistakes as medical wards. ME rates were greater in intensive care units. In order to improve pharmaceutical safety, the study emphasized the value of teamwork among healthcare professionals, including doctors, chemists, nurses, information engineers, and administrators. It was discovered that JCI certification enhanced MEs awareness, prevention, and quality enhancements. Overall, the study supported the 3-and-a-half-year intervention program's ability to reduce MEs

Examining the factors that influence medication administration errors and the reporting of these among mental health nurses in the hospital setting: a systematic review

Background/Aims A medication administration error is defined as ‘any difference between what the patient received or was supposed to receive and what the prescriber intended in the original order’. Medication administration errors are associated with increased morbidity and mortality. They occur frequently in the mental health setting and pose a serious risk of patient harm. The factors leading to medication administration errors in the mental health care setting is under researched and the potential for mental health services to prevent harm from medication administration error is unknown. The aim of this study was to understand factors that influence medication administration errors, and the reporting of these, among mental health nurses in the mental health hospital setting. Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (2015) checklist. A total of 3625 studies were identified, nine of which were included for final review. The CINAHL, Cochrane, EMBASE, Medline, Medline Ovid, Psych Info and PubMed databases were searched, as well as grey literature. Results Medication administration errors and their reporting are complex, multifaceted and show organisational and individual overlap. Heavy workload, staffing shortages, differing levels of experience, ward dynamics, lack of knowledge, interruptions, communication and patient interaction contributed to the occurrence of medication administration errors. Key factors included rationale on why not to report an error, lack of knowledge regarding how to report, what to report, as well as fear and stigma. Conclusions Many factors lead to the occurrence of a medication administration error or why they are not reported. More education is needed to help reduce medication administration errors. Further research may understand the behavioural patterns of mental health nurses and at-risk behaviour. This may help identify adequate interventions to reduce the risk of medication administration errors in this setting.

Pediatric nursing students’ self-efficacy regarding medication administration and clinical comfort and worry: A pre-posttest comparative study of nurse mentoring versus peer mentoring

AimThis study aimed to examine the effect of mentoring practice by graduate nursing students and clinical nurses on students’ self-efficacy in pediatric medication administration, clinical comfort and worry levels of students taking pediatric nursing courses. BackgroundChildren are a highly sensitive group against medication administration errors. Improving the self-efficacy of student nurses who will work with this group toward medication administration is essential. Mentoring programs can increase students’ skills and self-efficacy by reducing their stress levels during clinical practice. DesignThe research is a two-group pretest-posttest randomized controlled experimental research design. SettingsThe study was conducted in the pediatric units of a training and research hospital located in the Western Black Sea region of Turkey between October 1, 2022 and December 30, 2022, as part of the clinical practice of the Pediatric Nursing course in the fall semester of 2022–2023. ParticipantsThe study sample consisted of 143 students (peer mentoring group=73, nurse mentoring group=70) who were 3rd-year students taking the pediatric nursing course. MethodsParticipant information form, Medication Administration Self-Efficacy Scale in Children for Nursing Students (MASSCNS) and Pediatric Nursing Students Clinical Comfort and Worry Tool (PNSCCWT) were administered to the students before the clinical practice. Then, the groups received mentoring practice in the clinical practice area for 14 weeks. At the end of the practice, MASSCNS and PNSCCWT were administered to the students again. ResultsThe groups were homogeneously distributed when compared according to descriptive characteristics (p > 0.05). The self-efficacy scores of the students in both groups after clinical practice were significantly different from those before clinical practice (tnurse=-4.724, pnurse=0.000 <0.05; tpeer=−3.742, ppeer=0.001 <0.05). ConclusionsThis study’s results indicate that nurse mentoring and peer mentoring effectively increase nursing students’ self-efficacy during pediatric clinical practice. While nurse mentors decreased students’ worry, peer mentors increased students’ clinical comfort levels.