Paediatric Emergency Nurses’ Perception of Medication Errors: A Qualitative Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The topic is promising and will contribute to research in the scientific community. However, it would be beneficial to consider the following comments for further improvements:

 

1.   Title: Is clear and acceptable.

2.   Abstract:

The abstract of215 words is provided - it would be better if abstracts reflect the whole process/methods, questionnaire information, and inclusion & exclusion criteria of the present study, if any. The current layout does not truly reflect the present study. Also, what do you mean by “This study was not 28 registered”

3.   Introduction:

You could add some more parts about the current gaps, rationale for doing this present study.   

4.   Materials and Methods:

You can add more information about - how the questions are selected for the questionnaire? Is there help taken from experts?

5.   Results:

How you identify and analyse the emotions, thoughts and behaviours generated after an ME.

How many male and female participants participated in study?

How is the data categorized into various themes?

Is there thorough review and validation done to ensure consistency?

6.   Discussion:

Clear and presented satisfactorily. Needs to include more newer/recent references.   

7.   Conclusion:

Is clear and understandable.

8.   Limitation:

Needs to add limitation, as sample size is small, only 10 participants were included in the study. It is difficult to generalize the results to larger populations as small sample size.    

9.   References:

 

Few of the references are more than 10 years old, try to use new and relevant references wherever possible and available. Some references not fully written as reference number 8, 9, 10 and 11     

Comments on the Quality of English Language

The topic is promising and will contribute to research in the scientific community. However, it would be beneficial to consider the following comments for further improvements:

 

1.   Title: Is clear and acceptable.

2.   Abstract:

The abstract of215 words is provided - it would be better if abstracts reflect the whole process/methods, questionnaire information, and inclusion & exclusion criteria of the present study, if any. The current layout does not truly reflect the present study. Also, what do you mean by “This study was not 28 registered”

3.   Introduction:

You could add some more parts about the current gaps, rationale for doing this present study.   

4.   Materials and Methods:

You can add more information about - how the questions are selected for the questionnaire? Is there help taken from experts?

5.   Results:

How you identify and analyse the emotions, thoughts and behaviours generated after an ME.

How many male and female participants participated in study?

How is the data categorized into various themes?

Is there thorough review and validation done to ensure consistency?

6.   Discussion:

Clear and presented satisfactorily. Needs to include more newer/recent references.   

7.   Conclusion:

Is clear and understandable.

8.   Limitation:

Needs to add limitation, as sample size is small, only 10 participants were included in the study. It is difficult to generalize the results to larger populations as small sample size.    

9.   References:

 

Few of the references are more than 10 years old, try to use new and relevant references wherever possible and available. Some references not fully written as reference number 8, 9, 10 and 11     

Author Response

Comments 1: The abstract of215 words is provided - it would be better if abstracts reflect the whole process/methods, questionnaire information, and inclusion & exclusion criteria of the present study, if any. The current layout does not truly reflect the present study. Also, what do you mean by “This study was not 28 registered”

Response 1: Thank you very much for taking the time to review this manuscript, we have modified the abstract, and we have added more information.  

We add the phrase ‘This study was not registered’ if it was not previously registered because the journal requiered it.

Comments 2: You could add some more parts about the current gaps, rationale for doing this present study.

Response 2: Thank you for pointing this out, we have added a new paragraph about rationale for doing this present study, and a new reference (lines 53-55, reference 7)

“A Spanish study found that 12.3% of paediatric emergency department (PED) patients experienced an adverse event (AE), with 57.1% identified in later check-ups. Of these cases, 35.7% were medication related [7].”  

Comments 3: You can add more information about - how the questions are selected for the questionnaire? Is there help taken from experts?

Response 3: Thank you for pointing this out, we clarifies this point and have added a new paragraph on lines 98-103

“A question guide was followed during the interviews (Table 1). The question script was developed by the entire research team. The existing literature was reviewed, focusing on key questions related to the study objectives to develop the preliminary interview guide. After development of the questions, this interview guide was presented to two nurses with extensive experience in pediatric emergency care for review and feedback to ensure clarity and relevance and a final interview guide was obtained.“

Comments 4: How you identify and analyse the emotions, thoughts and behaviours generated after an ME.

Response 4: Thank you for pointing this out. We have expanded the information on data analysis in lines 116-136

Comments 5: How many male and female participants participated in study?

Response 5: The present study was conducted with only female nurses as participants. It is acknowledged that this is a limitation of the study.

Thank you for pointing this out, we clarifies this point and have added in the line 168

Comments 6: How is the data categorized into various themes?

Response 6: Thank you for pointing this out. We have expanded the information on data analysis in lines 116- 136.

Comments 7: Is there thorough review and validation done to ensure consistency?

Response 7: Thank you for pointing this out. We have expanded the information on data analysis in lines 116- 136.

Comments 8: Clear and presented satisfactorily. Needs to include more newer/recent references.   

Response 8: Thank you for pointing this out, we have added a new parragraph and a new references (line 431-433, and references 24,32,39)

Comments 9: Needs to add limitation, as sample size is small, only 10 participants were included in the study. It is difficult to generalize the results to larger populations as small sample size.    

Response 9: Thank you very much for your review, we have added:

The results presented are based on a limited sample size. Nevertheless, the findings encompass a diverse range of hospital and nursing characteristics, thereby facilitating extrapolation. In addition, we have reached theoretical data saturation. No new insights have emerged.  (487-490)

And, we have added in the line 174: The data saturation was achieved.

Comments 10: Few of the references are more than 10 years old, try to use new and relevant references wherever possible and available. Some references not fully written as reference number 8, 9, 10 and 11     

Response 10: Thak you for the correction. We have added the mising data.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review your manuscript. This is a continuing global issue and one well worth pursuing. I am surprised yours is the first one to potentially be the first to be published in Spain. I have a few observations I would like you to consider:

Abstract: Remove numbers related to your findings and state there are four main findings and relate to ..... etc

Line 34 needs a reference

Line 36- insert WHO after full version as you do use WHO later on in the manuscript

Line 56 reference should be Woo and Avery

Line 71 rephrase this sentence so it makes sense, so you remain objective to the methodology in general and then discuss the more specific in line 72.

Lines 132-136 does not make sense. I can't follow this thought process. 

Line 149 you have said participant discourse this should be analysis of the data

Line 227 heading should be Teamwork as one word

All quotes from participants should be indented and in italics. 

Reference 34 is missing from reference list as is Appendix A

Line

Author Response

Comments 1: Abstract: Remove numbers related to your findings and state there are four main findings and relate to ..... etc

Response 1 Thak you for the correction. We have removed the numbers

Comments 2: Line 34 needs a reference

Response 2:Thank you very much for your review. In the first paragraph we have referenced ‘Safety action Plan ’ We have added the reference

Comments 3:Line 36- insert WHO after full version as you do use WHO later on in the manuscript

            Response 3: Thank you very much for your review, we have inserted WHO

Comments 4: Line 56 reference should be Woo and Avery

Response 4:Thank you for your contribution. The suggested changes have been implemented.

Comments 5: Line 71 rephrase this sentence so it makes sense, so you remain objective to the methodology in general and then discuss the more specific in line 72.

Response 5: Thank you very much for your review, we have rephrased the paragraph: (line 78-84)

Comments 6: Lines 132-136 does not make sense. I can't follow this thought process. 

Response 6:Thank you for pointing this out. We have rephrased the paragraph: (159-164)

Comments 7: Line 149 you have said participant discourse this should be analysis of the data

Response 7: Thank you very much for your review, we have corrected it. Line 177

Comments 8: Line 227 heading should be Teamwork as one Word.

Response 8: Thank you for the correction. It was a mistake.

Comments 9: All quotes from participants should be indented and in italics. 

            Response 9: Thank you very much for your review. The suggested changes have been implemented

Comments 10: Reference 34 is missing from reference list as is Appendix A

Response 10:Thank you for the correction. The issue has been rectified.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

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