Safe Care for Pediatric Patients: A Risk Management Study in Pediatric Wards

This study aimed to identify and assess the risks present in the Pediatric Ward of a hospital in Region II, Philippines, and develop appropriate risk management and mitigation strategies to improve patient safety and healthcare quality. The study utilized a descriptive qualitative research design and employed document review, group discussions, and direct observation in data gathering. Risk management tools such as SWOT Analysis, PESTLE Analysis, Risk Matrix, and Risk Register were used to analyze internal and external factors affecting the Pediatric Ward and to identify potential clinical and operational risks. Findings revealed several strengths, including adequate staffing, willingness of personnel to learn, availability of medical equipment and supplies, established quality management systems, and effective patient cohorting practices. Opportunities identified included available trainings, government healthcare initiatives, technological advancements, and financial assistance programs. However, weaknesses such as limited pediatric emergency training, health record deficiencies, punitive reporting culture, poor ventilation, and increasing employee turnover were also identified. External threats included healthcare worker migration, budget constraints, cyber threats, emerging infectious diseases, and natural disasters. Risk Register analysis identified major risks such as needle stick injuries, medication errors, delayed patient care due to unavailable equipment and supplies, compromised staffing, poor ventilation, and documentation deficiencies. These risks highlighted the need for continuous monitoring, staff development, preventive maintenance, occupational safety practices, and efficient resource management. The study concluded that a comprehensive risk management plan is essential in strengthening patient safety, improving healthcare quality, and ensuring operational efficiency in the Pediatric Ward through proactive identification, assessment, and mitigation of risks.

risk management, pediatric ward, SWOT analysis, PESTLE analysis, & risk register

1. Agency for Healthcare Research and Quality. (2023). Patient safety culture surveys and quality improvement resources. U.S. Department of Health and Human Services. [Google Scholar] [Crossref]

2. Assiri, G. A., Shebl, N. A., Mahmoud, M. A., Aloudah, N., Grant, E., Aljadhey, H., & Sheikh, A. (2018). What is the epidemiology of medication errors, error-related adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open, 8(5), e019101. https://doi.org/10.1136/bmjopen-2017-019101 [Google Scholar] [Crossref]

3. Bouya, S., Balouchi, A., Rafiemanesh, H., Amirshahi, M., Dastres, M., Moghadam, M. P., Behnamfar, N., Shyeback, M., Badakhsh, M., & Allahyari, J. (2020). Global prevalence and device-related causes of needle stick injuries among health care workers: A systematic review and meta-analysis. Annals of Global Health, 86(1), 35. https://doi.org/10.5334/aogh.2698 [Google Scholar] [Crossref]

4. Centers for Disease Control and Prevention. (2022). Sharps safety for healthcare settings. U.S. Department of Health and Human Services. [Google Scholar] [Crossref]

5. Centers for Disease Control and Prevention. (2022). Ventilation in buildings. U.S. Department of Health and Human Services. [Google Scholar] [Crossref]

6. Centers for Disease Control and Prevention. (2022). Public health emergency preparedness and response capabilities: National standards for state, local, tribal, and territorial public health. U.S. Department of Health and Human Services. [Google Scholar] [Crossref]

7. Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage Publications. [Google Scholar] [Crossref]

8. Department of Health. (2023). National policy framework on patient safety. Department of Health, Philippines. [Google Scholar] [Crossref]

9. Gürel, E., & Tat, M. (2017). SWOT analysis: A theoretical review. Journal of International Social Research, 10(51), 994–1006. https://doi.org/10.17719/jisr.2017.1832 [Google Scholar] [Crossref]

10. Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., Laschinger, H. K. S., North, N., & Stone, P. W. (2012). Nurse turnover: A literature review. International Journal of Nursing Studies, 49(7), 887–905. https://doi.org/10.1016/j.ijnurstu.2011.10.001 [Google Scholar] [Crossref]

11. Hopkin, P. (2018). Fundamentals of risk management: Understanding, evaluating and implementing effective risk management (5th ed.). Kogan Page. [Google Scholar] [Crossref]

12. Institute of Medicine. (2007). Preventing medication errors. National Academies Press. [Google Scholar] [Crossref]

13. International Council of Nurses. (2022). The global nursing workforce and the COVID-19 pandemic. ICN. [Google Scholar] [Crossref]

14. International Organization for Standardization. (2018). ISO 31000:2018 risk management—Guidelines. ISO. [Google Scholar] [Crossref]

15. Jefferies, D., Johnson, M., & Griffiths, R. (2010). A meta-study of the essentials of quality nursing documentation. International Journal of Nursing Practice, 16(2), 112–124. https://doi.org/10.1111/j.1440-172X.2009.01815.x [Google Scholar] [Crossref]

16. Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Causes of medication administration errors in hospitals: A systematic review. Drug Safety, 36(11), 1045–1067. https://doi.org/10.1007/s40264-013-0090-2 [Google Scholar] [Crossref]

17. Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., García-Elorrio, E., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., ... Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196–e1252. https://doi.org/10.1016/S2214-109X(18)30386-3 [Google Scholar] [Crossref]

18. Marufu, T. C., Collins, A., Vargas, L., Gillespie, L., & Almghairbi, D. (2021). Factors influencing retention among hospital nurses: A systematic review. British Journal of Nursing, 30(5), 302–308. https://doi.org/10.12968/bjon.2021.30.5.302 [Google Scholar] [Crossref]

19. McKone-Sweet, K. E., Hamilton, P., & Willis, S. B. (2005). The ailing healthcare supply chain: A prescription for change. Journal of Supply Chain Management, 41(1), 4–17. https://doi.org/10.1111/j.1745-493X.2005.04101002.x [Google Scholar] [Crossref]

20. National Institute of Standards and Technology. (2024). Cybersecurity framework (CSF) 2.0. U.S. Department of Commerce. [Google Scholar] [Crossref]

21. OECD. (2022). Health at a glance: Europe 2022—State of health in the EU cycle. OECD Publishing. [Google Scholar] [Crossref]

22. Olsen, R. M., Hellzén, O., Skotnes, L. H., & Enmarker, I. (2014). Breakdowns in healthcare communication: An obstacle to patient safety. Journal of Multidisciplinary Healthcare, 7, 183–195. https://doi.org/10.2147/JMDH.S61260 [Google Scholar] [Crossref]

23. Occupational Safety and Health Administration. (2024). Bloodborne pathogens and needlestick prevention. U.S. Department of Labor. [Google Scholar] [Crossref]

24. Perera, R. (2017). The PESTLE analysis. Nerdynaut Publishing. [Google Scholar] [Crossref]

25. Perry, L., & Malkin, R. (2011). Effectiveness of medical equipment donations to improve health systems: How much medical equipment is broken in the developing world? Medical & Biological Engineering & Computing, 49(7), 719–722. https://doi.org/10.1007/s11517-011-0786-3 [Google Scholar] [Crossref]

26. Pronovost, P. J., Berenholtz, S. M., Goeschel, C. A., Needham, D. M., Sexton, J. B., Thompson, D. A., Lubomski, L. H., Marsteller, J. A., Makary, M. A., & Hunt, E. (2006). Creating high reliability in health care organizations. Health Services Research, 41(4 Pt 2), 1599–1617. https://doi.org/10.1111/j.1475-6773.2006.00567.x [Google Scholar] [Crossref]

27. Republic Act No. 7610. (1992). Special protection of children against abuse, exploitation and discrimination act. Republic of the Philippines. [Google Scholar] [Crossref]

28. Republic Act No. 9173. (2002). Philippine Nursing Act of 2002. Republic of the Philippines. [Google Scholar] [Crossref]

29. Republic Act No. 9184. (2003). Government Procurement Reform Act. Republic of the Philippines. [Google Scholar] [Crossref]

30. Republic Act No. 9439. (2007). An Act prohibiting the detention of patients in hospitals and medical clinics on grounds of nonpayment of hospital bills or medical expenses. Republic of the Philippines. [Google Scholar] [Crossref]

31. Republic Act No. 11332. (2019). Mandatory reporting of notifiable diseases and health events of public health concern act. Republic of the Philippines. [Google Scholar] [Crossref]

32. Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2024). Medical error reduction and prevention. In StatPearls. StatPearls Publishing. [Google Scholar] [Crossref]

33. UNICEF. (2023). The state of the world's children 2023: For every child, vaccination. UNICEF. [Google Scholar] [Crossref]

34. World Bank. (2022). World development report 2022: Finance for an equitable recovery. World Bank. [Google Scholar] [Crossref]

35. World Health Organization. (2009). Natural ventilation for infection control in health-care settings. WHO. [Google Scholar] [Crossref]

36. World Health Organization. (2021). Global patient safety action plan 2021–2030: Towards eliminating avoidable harm in health care. WHO. [Google Scholar] [Crossref]

37. World Health Organization. (2021). Global strategy on digital health 2020–2025. WHO. [Google Scholar] [Crossref]

38. World Health Organization. (2021). Roadmap to improve and ensure good indoor ventilation in the context of COVID-19. WHO. [Google Scholar] [Crossref]

39. World Health Organization. (2022). Medication without harm: WHO global patient safety challenge. WHO. [Google Scholar] [Crossref]

40. World Health Organization. (2022). Health worker safety charter. WHO. [Google Scholar] [Crossref]

41. World Health Organization. (2023). Global report on health data systems and capacity. WHO. [Google Scholar] [Crossref]

42. World Health Organization. (2023). Health workforce support and safeguards list 2023. WHO. [Google Scholar] [Crossref]

43. Yadav, P. (2015). Health product supply chains in developing countries: Diagnosis of the root causes of underperformance and an agenda for reform. Health Systems & Reform, 1(2), 142–154. https://doi.org/10.1080/23288604.2015.1026626 [Google Scholar] [Crossref]

• The Indirect Effect of Liquidity and Activity on Company Value with Profitability as an Intervening Variable
• Effect of Financial Skills, Knowledge, and Attitude on The Financial Behaviour of Clergy
• A Decade of Review: Trends in Budget Execution and Financial Performance of Development Projects in Tanzania (2014/15-2023/24)
• The Influence of Pre-Project Planning on the Budget Absorption Rate of Public Funded Infrastructure Projects in Kenya a Comparative Case Study of Narok, Migori, and Kisii County Government Projects
• Assessment of Factors Influencing Digital Transformation in Hotels’ Facility Management in Abuja Metropolis, Nigeria