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

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.

medication error; paediatric patients; health professionals; patient safety; Nigeria; nurses; physicians; pharmacists

1. Afolalu OO, Jordan S, Kyriacos U. Medical error reporting among doctors and nurses in a Nigerian hospital: a cross-sectional survey. J Nurs Manag. 2021;29(5):1007–1015. [Google Scholar] [Crossref]

2. Alghamdi AA, Keers RN, Sutherland A, Ashcroft DM. Prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care settings: a systematic review. Drug Saf. 2019;42(11):1423–1436. [Google Scholar] [Crossref]

3. Donaldson LJ, Kelley ET, Dhingra-Kumar N, Kieny MP, Sheikh A. Medication without harm: WHO's third global patient safety challenge. Lancet. 2017;389(10080):1680–1681. [Google Scholar] [Crossref]

4. Feyissa D, et al. Medication error and its contributing factors among pediatric patients diagnosed with infectious diseases admitted to Jimma University Medical Center, Southwest Ethiopia: prospective observational study. Integr Pharm Res Pract. 2020;9:147–153. [Google Scholar] [Crossref]

5. Gates PJ, et al. Prevalence of medication errors among paediatric inpatients: a systematic review and meta-analysis. Drug Saf. 2019;42(11):1329–1342. [Google Scholar] [Crossref]

6. Jessurun JG, Hunfeld NGM, Van Rosmalen J, Van Dijk M, Van den Bemt PMLA. Effect of automated unit dose dispensing with barcode scanning on medication administration errors: an uncontrolled before-and-after study. Int J Qual Health Care. 2021;33(4):mzab142. [Google Scholar] [Crossref]

7. Kishore P, Nikhithasri P, Ramya M. Assessment of medication errors in pediatric inpatient department of a private hospital. Int J Curr Pharm Res. 2017;9(6):70–75. [Google Scholar] [Crossref]

8. Mekonen EG, Gebrie MH, Jemberie SM. Magnitude and associated factors of medication administration error among nurses working in Amhara Region Referral Hospitals, Northwest Ethiopia. J Drug Assess. 2020;9(1):151–158. [Google Scholar] [Crossref]

9. Moriwaki M, Tanaka M, Kakehashi M, Koizumi M, Horiguchi H, Hayashida K. Influence of nursing time and staffing on medication errors: a cross-sectional analysis of administrative data. Nurs Rep. 2025;15(1):12. [Google Scholar] [Crossref]

10. Motta Robayo CL, Martínez Pinto J, Tabango Goyes B, Varela Chagüendo L, Duque Grisales E, Ballesteros-Ramírez R. Factors associated with medication administration errors in hospitalized pediatric patients: a scoping review. Ther Adv Drug Saf. 2026;17. doi:10.1177/20420986261478390. [Google Scholar] [Crossref]

11. Mueller BU, Neuspiel DR, Fisher ERS; AAP Council on Quality Improvement and Patient Safety, Committee on Hospital Care. Principles of pediatric patient safety: reducing harm due to medical care. Pediatrics. 2019;143(2):e20183649. [Google Scholar] [Crossref]

12. Satir AN, Pfiffner M, Meier CR, Caduff Good A. Prescribing errors in children: what is the impact of a computerized physician order entry? Eur J Pediatr. 2023. doi:10.1007/s00431-023-04894-5. [Google Scholar] [Crossref]

13. Um IS, Clough A, Tan ECK. Dispensing error rates in pharmacy: a systematic review and meta-analysis. Res Social Adm Pharm. 2024;20(1):1–9. [Google Scholar] [Crossref]

14. World Health Organization. Medication Without Harm: Global Patient Safety Challenge on Medication Safety. Geneva: World Health Organization; 2017. [Google Scholar] [Crossref]