Date of Award

Summer 2026

Abstract

Background: Due to the increased complexities of pediatric medication administration, preventable errors occur at a higher rate than in general adult populations. Rural emergency departments (EDs) often see fewer pediatric patients and have less specialized support available on-site. Nurse continuing education is an evidence-based intervention to reduce medication administration errors making it vital to supporting patient safety and maintaining pediatric readiness.

Local Problem: The microsystem is a rural, critical access hospital in northern New England. In 2021, the microsystem scored 66/81 on the National Pediatric Readiness Project’s (NPRP’s) ED Assessment. In 2026, the score dropped 11 points to 55/81. Contributing to this drop may have been an open Pediatric Emergency Care Coordinator (PECC) position within the microsystem. This resulted in less frequent pediatric-specific education. Over a three-month period, there were four pediatric intravenous (IV) medication administration errors - none of which resulted in an adverse event. However, combined this data supported targeted intervention to promote safe pediatric medication administration.

Methods: This quality improvement (QI) project used the FOCUS-PDSA framework to guide its development. The educational intervention consisted of a one-on-one session with the project leader to review best practices on pediatric IV medication administration, syringe pump use, and additional resources available to the staff. The impact was measured through a pre- post-survey with 10, five-point Likert-style questions assessing self-reported knowledge and confidence.

Results: Twenty-one nurses from the microsystem completed both the pre- and post-survey. All 10 measures assessed showed an increase post-intervention. Most notably, awareness of the NPRP increased by 44.3% and confidence using the syringe pump increased by 31.3%. A paired t-test was conducted and determined that eight out of ten measures were statistically significant (p < 0.05).

Conclusions: The implementation of this QI project increased nurse knowledge and confidence for pediatric medication administration best practices. These results support the effectiveness of short, targeted education interventions to promote safe, evidence-based pediatric patient care. Assessing the long-term impact on staff knowledge and confidence, utilization of the syringe pump, number of pediatric medication administration errors, and patient outcomes should be topics of future initiatives.

Document Type

Master's Thesis

First Advisor

Deborah Simonton

College or School

CHHS

Department or Program

Direct Entry Master's in Nursing

Degree Name

Master of Science

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