(01) Analyzing Medication Management Practice in Lower Middle-income Country

Title: Analyzing the Medication Management Practices in Lower and Middle-income Countries

Abstract : Basis of Inquiry
Medication management is a critical component of pediatric oncology nursing, ensuring patient safety and effective treatment delivery. However, inconsistencies in institutional policies across healthcare facilities can lead to variations in practice, increasing the risk of medication errors and compromising patient care. Despite global guidelines on medication safety, many hospitals, particularly in low- and middle-income countries, lack standardized policies that align with evidence-based practices.

Objectives
This project aimed to assess existing medication management practices in hospitals participating in the ICON project in Pakistan and Brazil, identifying gaps and opportunities for improvement.

Methods
Descriptive cross-sectional research was conducted to assess the medication management processes along with policy availability and content across key domains, including ordering, verification, storage, high-alert and emergency drugs, preparation, administration, and compliance monitoring. Additional criteria evaluated policy structure and evidence-based guidelines. A descriptive analysis was done for data collected. Hospitals with pediatric oncology services were included in the study.

Findings
The findings of medication management policy in Brazil and Pakistan revealed several key differences and areas for improvement. Brazil had near-universal medication management policies (96.2%), while Pakistan's coverage was lower at 60.0%.
Guidelines on completeness of order and responsibility to prescribe, prepare, and administer were higher in Brazilian (96%) compared to Pakistani (77.8%). Regarding the storage of medication (77.8% vs. 48.0%), high alert (100.0 vs. 83.3%), and emergency drug management (88.9% vs. 76.0%), Pakistani Hospitals had a higher presence than in Brazil.
Brazil's medication management policies had a strongly structured process, including references to evidence-based guidelines (84.0%) than in Pakistan (55.6%).
The findings highlighted the need for standardized, evidence-based policies for medication management through Interdisciplinary collaboration. Strengthening policy implementation through compliance monitoring and staff training is essential for adherence to best practices.