Factors influencing quality management of medication by nurses at Kenyatta National Hospital Paediatric wards
Background: Quality administration of medications is more than a mechanical task done in compliance with a prescription. Nurses must have basic knowledge of indications, dosages and side effects of medications to accurately interpret prescription orders. Safe drug administration ensures patients' drug safety, cost containment and reduced length of patient hospitalization. Pediatric nurses at KNH have been shown not to adhere to laid down procedures while administering oral medication to children. This could be attributed to several factors probably associated with the nurses' knowledge and practice, caretakers' contribution, care environment, hospital policy and availability of material and human resources. Our literature search did not find any study done on factors influencing quality management of medications by pediatric nurses in Kenya. Objective: The study sought to determine factors influencing quality management of medication by nurses at KNH paediatric medical wards. Methods: A descriptive cross-sectional survey involving 80 nurses, 180 caretakers and four nurse managers was done. Two sets of semi-structured researcher-administered questionnaires were issued. The first set was administered to nurses while the second one was employed on caretakers who had children in the wards. A written guide was used to conduct in-depth interviews with the nurse managers. , An observation tool was further used to collect data as nurses were administering medication. These tools collected both quantitative and qualitative data. Data analysis was done using SPSS software (version 16) while qualitative data was analyzed manually. Findings of the study were presented in bar graphs, pie charts and frequency tables. Results: High workload (90%), language barrier (56%), absence of paediatric formulations (55%), multiple tasks (21 %), lack of support (20%) and limited physical space (19%) were the main challenges that nurses encountered during drug administration. There was only one nurse (1.25%) trained in pediatric nursing. Our analysis revealed an association between quality drug administration and number of years worked in paediatric wards (fisher's exact p < 0.05) and the attendance of continuing medical education (CME) (Fishers exact p < 0.05). Conclusion: The findings in this study indicate a need for concerted efforts and partnerships among the pediatric care stakeholders (nurses, patients/caregivers, hospital management and ministry of health) in enhancing quality medication administration in the pediatric wards. This will boost the nurses' professional confidence in delivery of care and minimize errors in drug administration thus ensuring patient safety and quick recovery. The challenges faced by paediatric nurses should be addressed by the hospital administration if quality administration of medication is to be achieved. The study duration and budget: The study took eleven months to complete at an estimated cost of Kshs.l05 060. Funding was provided for by KNH, the researchers' employer.