How Nurses Maintain High‐Risk Medication Safety in Paediatric Intensive Care

BACKGROUND: Existing research has focused mainly on high-risk medication errors, contributory factors and process-based interventions; less is known about nurses' everyday safety work in paediatric intensive care. AIM: To explore how nurses maintain high-risk medication safety in paediatric intensive care. STUDY DESIGN: A descriptive qualitative study using purposive sampling, critical incident interviews and inductive content analysis at a tertiary children's hospital in China. RESULTS: Ten nurses participated. Four themes were generated: anomaly recognition and proactive verification; team communication and continued follow-up after risk identification; safety checks and bedside adaptations in medication practice; and learning from near misses and adjusting future practice. Together, these practices spanned order review, preparation, administration, pump and compatibility management, monitoring and team learning. CONCLUSIONS: Experienced nurses in paediatric intensive care maintained high-risk medication safety through linked practices of anomaly recognition, proactive verification, team communication, continued follow-up, safety checks, bedside adaptation and near-miss learning. RELEVANCE TO CLINICAL PRACTICE: Training and workflow support should strengthen anomaly recognition, dose and infusion-rate recalculation, communication, active double checking, compatibility checking, infusion-pump management, follow-up monitoring and near-miss learning.