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NURSING STUDENTS’ PEDIATRIC MEDICATION KNOWLEDGE

Introduction
Medication administration in pediatric nursing is a highly critical and complex aspect of

healthcare practice that demands specialized knowledge, precision, and skill. Children differ

physiologically from adults due to immature organ systems, variable metabolic rates, and

fluctuating body weights that significantly influence drug absorption, distribution, and excretion.

Consequently, nursing students must receive structured education and ongoing evaluation to

ensure safe and effective medication administration to children (Akça & Berşe, 2023).

Administering medications to pediatric patients represents one of the most challenging

and high-risk responsibilities in nursing. This complexity arises from the physiological and

pharmacokinetic differences between children and adults, where factors such as body weight,

body surface area, and organ maturity determine accurate drug dosages. As a result, pediatric

medication administration is highly vulnerable to human error, with medication errors

recognized as a leading cause of preventable harm in pediatric care (Davies et al., 2015;

Rushforth, 2007; Lee & Quinn, 2019).

Patient safety remains a cornerstone of nursing education. The World Health

Organization (2011) emphasizes, through its Patient Safety Curriculum Guide, that nursing

programs must cultivate a culture of safety early in training, particularly in medication

management. During clinical practice, nursing students are expected to adhere to the “five

rights” of medication administration right patient, right drug, right dose, right route, and right

time. However, in pediatric contexts, these principles are complicated by the need for weight-

based calculations and age-related dosage adjustments. Even minor deviations in calculation or
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NURSING STUDENTS’ PEDIATRIC MEDICATION KNOWLEDGE
timing can result in serious adverse drug reactions, underscoring the importance of accuracy,

critical thinking, and adherence to pediatric protocols (Castañeda, Planells, & Mulet, 2022).

Despite structured curricula, nursing students often experience anxiety, lack of

confidence, and limited practical exposure during clinical placements, which can increase the

likelihood of medication errors such as incorrect dosages, omissions, or inaccurate

documentation. Studies indicate that enhanced mentorship, simulation-based training, and

continuous competency assessments can mitigate these risks and improve students’ confidence

and performance (Bulduk, Can, & Muhafiz, 2024).

Competence in medication administration can be developed and assessed through

multiple modalities, including classroom teaching, online learning, and simulation laboratories.

Evaluation methods such as Objective Structured Clinical Examinations (OSCEs) and Direct

Observation of Procedural Skills (DOPS) are increasingly employed to assess nursing students’

practical proficiency in safe medication practices (Irvine, Whiteing, & Andrew, 2025).

Common medication errors among nursing students in pediatric settings include incorrect

dosage calculations, inappropriate preparation, and failure to verify drug compatibility or timing.

Such errors not only jeopardize patient safety but also erode trust in healthcare systems.

Therefore, integrating evidence-based teaching strategies, realistic simulations, and structured

feedback mechanisms is essential to strengthen students’ clinical reasoning and medication safety

competencies (Shahzeydi et al., 2022).

Globally, medication administration errors (MAEs) are recognized as a major preventable

issue, particularly in pediatric care where the margin for error is exceedingly small. Due to

smaller body sizes, developing organ systems, and the necessity for weight-based dosing,
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NURSING STUDENTS’ PEDIATRIC MEDICATION KNOWLEDGE
children are especially susceptible to adverse drug events (ADEs) from even minor

miscalculations or timing errors, which may lead to serious complications, prolonged

hospitalizations, or mortality (Nukpezah, Anyaba, & Osman, 2024).

Assessing nursing students’ knowledge and competence in pediatric medication

administration is therefore vital. Identifying existing knowledge gaps and reinforcing learning

strategies can help prepare future nurses to manage pediatric medications safely and effectively.

Regular assessment and targeted educational interventions not only enhance clinical performance

but also contribute directly to safer pediatric care and the reduction of preventable medication

errors (Fuster-Linares et al., 2022).

Significance

Medication administration in pediatric nursing is a complex and high-risk task that

requires precise pharmacological knowledge and accurate calculation skills. Pediatric medication

errors occur more frequently and with greater severity than in adult care due to children’s

physiological differences and the need for weight-based dosing. Studies have identified

inadequate knowledge and poor calculation abilities as major contributors to such errors among

nursing students and practicing nurses (Hsaio et al., 2010; Wong et al., 2009).

Research indicates that over 60% of pediatric medication errors involve incorrect

dosages, often resulting in adverse outcomes (Kaushal et al., 2001; Stratton et al., 2004). Limited

clinical experience and low self-efficacy among nursing students further increase this risk (Wiley

Online Library, 2023). Educational interventions, such as medication safety programs, have been

shown to significantly reduce these errors and improve nurses’ performance (Menoufia Nursing

Journal, 2020).
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NURSING STUDENTS’ PEDIATRIC MEDICATION KNOWLEDGE
Therefore, assessing nursing students’ knowledge and identifying common medication errors

during clinical training are essential for developing targeted educational strategies that enhance

competence and promote safer pediatric medication practices.

Aim of the study

To assess nursing students’ knowledge regarding pediatric medication administration

procedures and identify common medication errors committed during clinical training.

Research Questions

Q1: What is the level of nursing students’ knowledge about pediatric medication administration

procedures?

Q2: What are the most common types of medication errors made by nursing students during

clinical training?

Q3: Is there a relationship between the level of knowledge and the level of knowledge and the

occurrence of medication errors among nursing students?