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Abstract Children safety is a central concern of current health-care delivery systems worldwide, medication safety is an important part of this safety and is an indicator of health care quality (WHO, 2017).Safe and effective medication administration requires that nurses have the necessary skills and competencies to deliver high quality care and prevent medication errors (Kim et al., 2013). Medication errors and adverse drug events are common in pediatric patients’ wards and in particular children with multiple medications or have longer hospital stays and those with co- morbidities, were at greater risk for medication errors or adverse drug events .These errors can significantly affect children safety and result in hazards for children and their families, so medication safety process aims at the reduction of medication errors rates and their earlier identification before the child gets harmed (Dedefo et al., 2016). Pediatric medication errors can be reduced through multiple interventions aimed at improving the medication process and maintaining children safety (Kahn et al., 2018). Pediatric nurses have a key role in monitoring, notifying, education and prevention of these errors. Implementation of a structured educational intervention and counseling for health professionals and nurses play an important role in reduction of medication errors rate (Wong et al., 2009). Prevention of medication errors is not simple. So, analyzing its causes help in their prevention, whether by reviewing the work processes, training nurses and health professionals, incorporating technological resources, developing educational methods, tools, and creating protocols to enhance children safety.Also, attention should be directed to the other aspects which causing medication errors such as lack of nurses, work load, nurses’ attitude, low wages and environmental factors (Yamamoto et al., 2011). The purpose of the study was to:- 1. Elicit of proposed protocol for safety medication administration. 2. Evaluate the effect of proposed protocol for nurses on children medication safety. Research design:- A quasi- experimental design (Pre, Post and follow up tests) was used. Setting:- This study was conducted in the pediatric wards at EL Menoufia University Hospital and Shebin El_kom Teaching Hospital. Subjects:- A convenience sample of 50 nurses was obtained from the previously mentioned settings (35 nurses from the pediatric ward at Menoufia University Hospital and 15 nurses from the Pediatric Ward at Shebin El_kom Teaching Hospital). Instruments of the study:- Three instruments were utilized for data collection: Instrument one: Structured interviewing questionnaire: It was divided into two parts: Part one: Social characteristics of studied nurses. Part two: structured questionnaire to identify nurses’ knowledge about medication administration, causes of medication errors, causes of not reporting these errors and strategies for prevention of these errors. Instrument two: Structured Observation form for direct observations(medication observation form). It is developed by Harkanen (2014) and modified by the researcher. It was used to observe nurses’ during preparation and administration of medication and detecting medication errors. Instrument three: medication safety audit list for nurses: It was developed by ministry of health of singapore (2006) and modified by the researcher. It was used to assess children medication safety. The main results of the study showed that: 1- More than half of studied nurses (60.6%) were ≥30 years old. 2- All of studied nurses (100%) did not attend any previous training courses related to medication safety. 3- Less than half of studied nurses (46%) were graduated from Technical Nursing Institute. 4- More than half of studied nurses (60%) had ≥5 years of experience in Pediatric Nursing. 5- Total mean scores of nurses’ knowledge about medication errors on pretest were 8.02 ± 3.7 compared to 13.64 ± 2.09 and 12.58 ± 1.6 on post and follow-up tests respectively. 6- Total mean scores of nurses’ knowledge about different routes of medication administration (oral, IM, IV, SC) were 16.82 ± 4.6 on pretest compared to 23.34 ± 2.8 and 23.14± 1.6 on post and follow-up tests respectively. 7- Total means scores of medication observation form were 14.84 ± 1.4 on pretest compared to 16.80 ± 1.7 and 14.82 ± 0.96 on post and follow-up tests respectively.Total mean scores of nurses ’knowledge about medication safety audit list were 6.64 ± 0.67 on pretest compared to 9.1 ± 0.71 and 8.1 ± 0.86 on posttest and follow-up test respectively. 9- There were positive correlation between total knowledge of nurses and child medication safety 10- There were positive correlation between total knowledge of nurses and total medication observation form 11- There were positive correlation between total medication safety audit list and total medication observation form The study concluded that: Implementation of the proposed protocol for nurses on children medication safety improved nurses’ knowledge and practices regarding medication safety for pediatric patients. Also, it contributed to detect the most common medication errors among pediatric nurses Based on the results of the study it was recommended that: 1. Ongoing in-service education programs about children medication safety should be designed and implemented at all pediatric units to improve pediatric nurses’ knowledge and practices on the basis of nurse’s actual needs. 2. Proposed protocol regarding medication safety should be used by pediatric nurses in all pediatric units. 3. In service training units should be established in each hospital to enhance nurses’ knowledge and practice regarding medication safety. 4. Future studies should be applied on a larger sample to investigate the effect of proposed protocol for nurses’ on children medicationsafety to ensure generalizability of the results, and should be a part of health care provided in all hospitals. |