Medication Errors Among Health Professionals in a Nigerian Tertiary Paediatric Department: Stages, Types, and Associated Occupational Factors

Abstract

Background: Children remain disproportionately vulnerable to medication errors because of weight-based dosing, limited ability to communicate adverse effects, and the frequent use of formulations designed primarily for adults. Data describing where in the medication-use process these errors originate, and which occupational factors are associated with them, remain scarce in Nigerian tertiary hospitals. Objective: To evaluate the stages of the medication-use process and the types of medication error reported by physicians, nurses and pharmacists in a paediatric department, and to examine associations with occupational characteristics. Methods: A descriptive cross-sectional survey was conducted in 2020 among 89 health professionals (physicians, nurses and pharmacists) in the paediatric department of a Federal Medical Centre in South-South Nigeria, using a structured, self-administered questionnaire. Descriptive statistics summarised frequencies and percentages, and the Pearson chi-square test assessed associations between professional cadre and error stage or type, with p<0.05 taken as significant. Results: Transcribing (92.2%) and drug administration (92.1%) were the stages most frequently implicated in medication error, followed by dispensing (82.0%); the association between professional cadre and error stage was statistically significant for transcribing, dispensing and administration (p<0.05). Wrong dose was reported by all respondents (100.0%), and dose error was the single most common predominant error type (40.5%), driven mainly by overdose (51.7%). Route errors (23.6%), dominated by inappropriate route (49.5%), and frequency errors (17.9%) followed. Nurses and physicians accounted for the bulk of reported dose and route errors, with pharmacists more concentrated in dispensing-related error. Conclusion: Medication error in this paediatric department clusters at the transcribing and administration stages and is dominated by dosing error, implicating both systemic (paper-based, multi-step transcription) and human factors (workload, cadre-specific task exposure). Targeted interventions at these two stages, rather than uniform hospital-wide measures, are likely to yield the greatest reduction in risk to paediatric patients.