Background: Medication errors are probably the most common type of child safety
incidents worldwide and cause harm to neonates, distress to medical staff and costs to the
health care system. The study aimed to assess medication preparation errors among staff
nurses at Neonatal Intensive Care Units. Research Design: A descriptive analytical research
design was utilized. Research Settings: This study was conducted at Neonatal Intensive
Care Units belong to two University Hospitals the Children Hospital & Obstetric Hospital
affiliated to Ain Shames University Hospitals, Abo-Elrish Children Hospital and New El-
Kasr El Ainy affiliated to Cairo University Hospitals. Subject: A purposive sample consisted
of 60 nurses at the previously mentioned settings regardless their age, gender, and
qualification for a period of 6 months. Tools: Two tools were used a pre designed
questionnaire sheet to assess knowledge of the studied nurses about medication preparation
errors and observational checklists sheet to assess nurses' practice regarding medication
preparation errors. Results: More than one third of studied nurses do not know the
precautions during medication preparation and half of studied nurses asked the pharmacist to
change medication sticker when had difficulty to read medication name. More than two
thirds of studied nurses needed to know information before medication administration, while
more than one third of studied nurses combined oral medication with artificial milk and more
than two thirds of them didn't clarify medication label. Conclusion: The current study
concluded that, the common medication preparation errors among the studied nurses were
did not know precautions before leaving medication preparation, combined oral medication
with artificial milk, didn't know clarify medication label, didn't know ten medication rights,
didn't know precaution before oral medication administration, review the incubator card
before medication administration and didn't monitor/assess child before medication
administration. Recommendations: Periodical educational programs for enhancing level of
nurses' knowledge and practice for prevention of medication errors and emphasize the
importance of implementing the effective error prevention strategies, increasing the nurse to
neonate ratio and participation of pharmacy department in drug preparation.