Factors associated with medication administration errors in hospitalized pediatric patients: A scoping review.

BACKGROUND: Medication errors are a leading preventable cause of harm in hospitalized children. The pediatric population is particularly vulnerable due to weight-based dosing requirements, developmental pharmacokinetic variability, and limited capacity for self-advocacy. OBJECTIVES: To map and synthesize the available evidence on factors associated with the occurrence of medication administration errors in hospitalized pediatric patients. ELIGIBILITY CRITERIA: Studies addressing administration phase medication errors (per the National Coordinating Council for Medication Error Reporting and Prevention, NCC MERP) in hospitalized children aged 0 to 18 years, published in English, Spanish, or Portuguese, using quantitative, qualitative, or mixed methods designs. SOURCES OF EVIDENCE: Nine electronic databases were searched from inception to July 2026 using English, Spanish, and Portuguese (DeCS) terms, supplemented by hand searching of reference lists. CHARTING METHODS: The review followed the Joanna Briggs Institute (JBI) methodology; data were charted with the JBI standardized instrument and synthesized narratively with thematic analysis. RESULTS: Of 1,012 records, 25 studies met the inclusion criteria. Incorrect dosing was the most prevalent error type (18 studies, 72%). Neonates and infants were the most vulnerable group, and PICU and NICU the highest-risk settings, although a direct observation study reported that 37% of administrations on general wards involved an error. Human factors, particularly knowledge deficits, were the most frequently reported contributors (13 studies, 52%). Five complementary mitigation strategies were identified: professional education, dual verification, unified non-punitive reporting, technology, and interprofessional communication. CONCLUSIONS: Medication administration errors in pediatric inpatients are driven by a multilayered interplay of human, environmental, communicative, and medication related factors. Effective prevention demands integrated, systems-based approaches combining education, technology, standardized protocols, and a non-punitive safety culture.