Nursing Essay Paper on Error Minimization in Medical Nursing

Error Minimization in Medical Nursing

Abstract

Nursing practice is a professional field that is characterized by competence and safety of patients. These factors are crucial any time a patient is taken through medical care management. However, several cases of patients’ deaths due to medical errors or malpractices have been reported. The main contributing elements of this scenario are nurses’ level of competence contributed by lack of skill upgrading besides malpractices (or carelessness) in Medicare service provision. The paper aims to address these factors based on educational strategies by adopting continuous use of research findings in nursing field. This is expected to minimize errors that are common in nursing practices, particularly during medical administration. Variables of concern in errors mitigation include correct dosage utility, patient identification, relevant drug and route pre-determination besides correct timing for administration of medication. Qualitatively, several literature materials on the subject matter have been analyzed and important information used to draw recommendations and conclusion. From the different analyses carried out, education function is an important element that can be adopted in order to improve service delivery in nursing practices. This is possible by ensuring consistency in improving nurses’ level of expertise through active involvement in relevant research works. From the facts collected, it is evident that there exists a significant linear relationship between nurses’ level of expertise and degree of medication errors. That is, increase in level of expertise causes a significant drop in nursing malpractices while a decrease in nurses’ competence results to increased rate in occurrence of errors. Therefore, provision of comprehensive and systematic control measure through skill upgrading is an important control tool, which has the potential to address quality challenges affecting nursing services in medical institutions.

Key Words: Nursing, medical services, errors, skill upgrading

Problem Statement

Developing a Question

The components of PICOT

P- In adult patients undergoing knee replacement surgery

I- What is the impact of education

C- Compared to other external factors

O – On the recognition, resolution, and prevention of medication errors

T- During surgery

PICO question. In adult patients undergoing knee replacement surgery, what is the impact of education compared to other external factors in nursing on the recognition, resolution, and prevention of medication error during surgery?

 Identifying the Problem. In the contemporary healthcare setting, pharmacological concepts are created to ensure the positive therapeutic outcome is achievable, especially for surgery patients while preventing cases of inadequate drug reactions. There are patients who die yearly in medical institutions because of preventable medication mistakes. Medication is a fundamental aspect in a nursing role since it associates with risks. In nursing, caution must be ensured to shun cases of medication mistakes. This is because nurse practitioners are responsible in administering medications. A medication error is a common problem in professional practice. Moreover, such medication errors not only result in death cases but also significant financial burden. Medication errors in nursing as a shared problem across various surgical disciplines can be solved through education. Medication errors have also weakened support and confidence in nursing and the entire healthcare setting.

The study will focus on the strategic role that education plays in preventing errors in contemporary nursing, especially when administering medication during surgery. It will include the aspects of safe medication delivery to surgery patients, such as the correct dose, right patient, correct route, right drug, and time. The study will analyze the complexity of the nursing role in surgery and system factors that may cause medication errors. In present-day nursing, there are fundamental nodes in medication administration where such errors occur. In surgery, they include documenting, administering, and monitoring. Moreover, medication errors happen due to poor handwriting in cases of prescription, especially when handling written or printed orders. Nurse practitioners should be aware of such cases since it may involve dangerous abbreviations

Education has demonstrated to be one of the most significant aspects in preventing errors during medication. The study will prove how education is an integral aspect in detecting and solving medication errors. Nurse practitioners involved in medication administration in the contemporary health system are well educated and competent on current medications. Such levels of competency enable nurses to detect cases of error more quickly and intercept, regardless of the source before they reach the intended surgery patients. The application of information technology in handling medication, including handheld computers has facilitated the elimination of overdependence on handwritten order medication. Nurse practitioners have also been able to access standardized medication protocols and policies to assist in avoiding cases of confusion.

Contemporary nursing practice has ensured nurse practitioners who handle surgery patients are competent enough to avoid the incidence of medication errors. This improves the general outlook of nursing system. In addition, nurses also promote progressive monitoring of medication error, potential cases through educating fellow nurses on the significance of medication awareness. Moreover, the implementation of medication errors in nursing is a significant aspect in the general healthcare system following the consistent cases of errors that may occur in hospital settings, especially with surgery patients. Healthcare practitioners, handling surgery patients should therefore put safety first ahead of timelines, especially nurses. Nurses have to exercise caution when handling medication, and when errors occur, they should report it since there are chances that it could also happen to other patients in related circumstances. In surgery rooms and the possible solutions as experienced by nurses in Finland, Britain, and

America. The article uses statistical information collected using interviews and analyzed through qualitative analysis. The article concludes by proposing that balance of medication error-making should be first recognized as significant in order to learn from them. Moreover, this includes reporting of incidents and adopting a strategic reporting system to handle such cases

Implementation Plan

A gap analysis conducted in June uncovered three essential open doors for development identified with nursing research, education support, subsidizing, and access to predictable and unified assets. Regarding educational assistance, most registered nurses and hospital authorities reported a requirement for formal training in the research process. A number of the nurses expressed that they would not know where to start in planning a research analysis, performing a literature review, or creating a configuration. Regarding financing, there is an apparent need for cash to pay staff nurse discharge time to deal with research projects. This is a bit astonishing in that discharge time of 80 hours is incorporated with the Chapman Nurse Scholar recompenses; in any case, the discoveries may demonstrate a need for extra training in regards to the supports that are accessible for research (Polit & Beck, 2008). concerning access to predictable and unified assets, those interviewed disclosed their disappointment for not being able to receive necessary assets to support them with research projects and in addition challenges in exploring the research process (e.g., finishing fundamental IRB structures and discovering a standard agent.) These findings point to the absence of a composed foundation to facilitate nursing research in most public institutions (Knapp, 1998).

Purpose .To ensure excellence in nursing and nature of consideration as well as give the Best Patient Experience, the Division of Nursing in every hospital tries to further create and stretch its program of research and evidence-based practice. Such a try is fundamental to nursing’s capacity to pull in and hold a lively workforce as well as to guarantee the health facility’s successful and continuous magnet re-assignment.                                                 Objectives. The essential objectives of this challenge are three-fold:

  1. To create a culture of research that energizes and backs nurses at all levels of the association in making inquiries that develop evidence-based practice and construct new nursing learning;
  2. To build the visibility and achievement of nurses both within and broadly across the nation, through distribution of the outcomes of their research and evidence-based practice projects at suitable discussions; and
  3. To increase the security and viability of health care through nursing research and evidence-based practice projects.

Other objectives include supporting the Long Term Quality Plan (e.g., to give healthcare that is protected and successful) and to maintain and develop an environment of nursing excellence that is consistent with our assignment as a Magnet Hospital.

Leading Principles. As nursing attempts to actualize this key plan, the following will serve as controlling standards:

  • Nursing practice must be based on the best accessible proof.
  • Nurses in immediate healthcare positions need to be highly skilled in discovering, assessing, and utilizing evidence to enhance nursing practice and give the Best Patient Experience.
  • Nursing administration must be eagerly occupied with supporting nursing research and evidence-based practice at the unit, departmental, divisional, and health center levels.
  • Appropriate assets (cash and work force) must be accessible to form a powerful nursing research and evidence-based practice system and foundation.
  • A system of research and confirmation based practice is fundamental to build a progressing environment of nursing quality and accomplishments proceeded with Magnet re-assignment.

Future Vision. As the Division of Nursing actualizes this vital project plan for research and evidence-based practice, the following serves as its desired future:

A culture of research and advancement will be apparent over all zones where nurses practice at the hospital. This culture of research and development will show itself through nurses addressing verifiable works, investigating evidence-based writing, and actualizing practice advancement to guarantee that the mind is protected, powerful, and gives the Best Patient Experience. Nurses will be trained in discovering and evaluating evidence as well as utilizing nursing’s imparted authority procedure to actualize required approach and practice advancement focused around undertaking results. It will be a desire for nurses at the unit or departmental level to eagerly seek opportunities that lead little scale research projects and unit-based practice advancements. Similarly, nursing will customarily partake in multi-site supported research studies and in interdisciplinary research. To support a culture of research and advancement, the Division of Nursing will have a dynamic system of instruction and tutoring set up. Progressing instruction in regard to research and evidence-based practice will be accessible through a mixture of discussions intended to help nurses at all levels. These discussions include formal courses, internet learning, diary clubs, lunch and lessons, and yearly research gatherings. Experts and doctorial-arranged nurses will be promptly available to serve as research and evidence-based practice guides for bedside staff nurses. Guides will be allocated to staff nurses new to the research process. What’s more, they will be accessible to guide nurses in proposal, conceptual, publicity, and presentation advancement and to give progressing help with respect to the research process. Nurses over the association will be taught about the instruction and tutoring open doors accessible, and will know how to effortlessly get to these opportunities.

Financing for nursing research and proof based practice opportunities will be accessible to nurses at all levels of the association. Nursing will have a dynamic project of craftsmanship and will look for award financing from a number of sources. What’s more, nursing will have assets set up to help medical caretakers with the stipend composing methodology. It will keep on meeting expectations with the various institutions to look for generous backing for research and confirmation based practice ventures.

At last, medical caretakers will impart the discoveries and conclusions of their tasks at the national, territorial, and doctor’s facility levels through publicity and platform presentations and distributions in expert diaries. Both coaching and money related support will be accessible to help publication improvement, and to support attendants who will be making a trip to national conferences to defend their work.

Goals (The First Year of the Project Plan)

  Goal 1: Develop an infrastructure that support the progress of nursing research as well as evidence-based practices that include rules, policies, and steps as well as monetary assistance other than the Chapman Nurse Scholars rewards
    Approach   Outcome   Specifics
  Build up process to record primary researchers within nursing Complete     Procedure developed and passed by the Research Committee and distributed to the IRB and the
  Strengthen process for evaluation and start off on research proposals from nurses submitted to the IRB, and be in touch with the hospital departments of Research and the leading doctors Complete   Procedure developed and accepted by the Research Committee and distributed to the appropriate parties.  
Make sure that nurses are involved on all suitable IRB panels Complete   According to the leading doctor, all IRB boards have nurses    
    Goal 2: Offer training and mentorship opportunities to increase the capacity of nurses to undertake and be involved in research and proof based practices. Approaches Outcome Specifics   Increase the responsibility of Nursing Research professional financial financial support available   Tried to increase the present research consultant duration to twice a week;   Build up and convey vital nursing research classes necessary for every Chapman Scholar and accessible to any fascinated nurse In progression   The present research consultant is incapable of providing service. Contract Willy University to offer this service   Increase monthly lunch cycles on tender development, text for newspaper, and summary/poster improvement Initiated and ongoing   A List of subjects and presenters developed by Research Committee. First session to take place on August 14th  
         
         
Goal 3: Boost the figure of nursing research and evidence-based practice studies conducted in hospitals
Approaches Result Specifics
Investigate and increase opportunities to take part in outside projects with NMH as a data collection site   Initiated and continuing   Two outer activities as of now through IRB and in information gathering stage: (1) a 12 month multi-site reduction study being directed on 10 of our med/surge units; and (2) An investigation of the Zassi Fecal Containment System in the MICU financed by the Hollister Corporation for $22,300. Nurses also took part in a review of nurse’s impression of seasonal influenza inoculations directed by Kinsey of Northwestern University. In excess of 200 nurses reacted to the review.
Discover prospects for staff involvement in interior research study   Initiated and continuing   Staff nurses serving as information gatherers for both the Falls and Zassi studies. Similarly, there have been three studies finished in the not so distant future with nurses as PIs or co-PIs. There are also two right now in the information gathering stage, and two that are get ready for IRB approval.
Build forums for attracted nurses to get together to talk about research thoughts and jointly come up with proposals Initiated and continuing   The research tan sack snacks, which will begin in August, will serve at this gathering.  
 Embark on discussing and identifying vital areas of research that are of main concern for Division of Patient Care Services postponed   The sessions are intended to be interactional and casual.  

Goals (The Second Year of the Project Plan)

  1. Continue to create a framework to back the progression of nursing research, and confirmation-based practice that incorporates approaches and forms as well as budgetary support past the Chapman Nurse Scholars.
  2. Provide training and coaching to build nurses’ ability to lead and take part in examination and proof based practice projects.
  3. Continue to build the amount of nursing research and proof based practices studies led at the hospital
  4. Disseminate and decipher discoveries of examination and EBP projects inside NMH, locally and broadly.

Goals (The Third Year of the Project Plan)

  1. Continue to assemble a framework to back the progression of nursing research, and confirmation based practice that incorporates approaches and forms as well as additional money related backing past the Chapman Nurse Scholars.
  2. Continue to give instruction and coaching to expand medical attendants’ ability to lead and take part in exploration and proof based practice projects.
  3. Continue to expand the amount of nursing research and proof based practices studies led at NMH
  4. Disseminate and decipher discoveries of exploration and EBP projects inside NMH and additionally, territorially, and broadly.

Evaluation Plan

Usually, nursing institutions are in consistent move to ensuring effectiveness in type of services being offered in terms of expected standards. This is achieved through preparation and subsequent implementation of change programmes that can be in form of training, appraisal recommendations, change management, staff satisfaction policies among others. However, implementation of these factors is not sufficient in an organization or institution until an evaluation is carried out. The main objective of the evaluation exercise is to provide a measuring guideline on how much success has been realized after the implementation exercise of the proposed solution. That is, it helps an institution gauge whether or not it is moving in the right direction as determined by its overall objectives and missions.

 There are several methods for evaluating proposed solution to problem affecting nursing practices. However, effectiveness of an evaluation method is determined by the method used or proposed for solutions needed.

Proposed solution to numerous death cases of patients due to nursing malpractices (errors) and substandard services (low quality) as reported by Kohn et al (2000) and the Institute of Medicine (2001)  respectively involves nurses’ active involvement in research findings by reviewing released research articles. This can be achieved by providing articles to practicing nurses within the organization on annual bases. After every release of research work or findings, the information would be made available through various media (print, discussions or departmental up-date meetings). Then, respective nurses would be expected to make a presentation of the learnt concept during the internally organized conference forum. Main variables to be assessed during this exercise include nurses’ attitudes to continuous learning, level of comprehension after critical review of research findings, time taken to understand the new research findings, challenges encountered during review exercise, level of satisfaction, effectiveness of the programme through improvement in service delivery besides customer responses (that is, reduced cases of complains that result from errors and low quality service providence)  (Kohn et al 2000; Institute of Medicine, 2001).

Assessments of these variables would be carried out by two major methods. These include quantitative and qualitative approaches (Section 3, n.d).

With quantitative methods of evaluation, data would be collected on the population to whom the project is meant to affect. These would be grouped into two. That is, nurses who would have taken the project positively and those who would be affected negatively by the proposed project as determined by turnover rates and level of standard in performance before and after the review exercises (Section 3, n.d; Kohn et al 2000; Institute of Medicine, 2001). The method would be used during the project process, impact assessment and post-project outcomes. Results obtained would then be used to draw conclusions and possible recommendations to the stakeholders on the way forward. Quantitative approaches to be used are counting systems besides survey method.

Under counting systems, the main items to be used are three types forms (contact or encounter form, item distributed and item received forms). The forms would be designed such that all important information concerning the programme is included. These would then to record respective events of the programme. The forms would be designed as shown in appendix A.

Apart from forms, survey technique would also be adopted. This method is essential in collecting numerical data on variables being measured. Survey instruments, such as questionnaires, personal interviews, mails and telephone conversation and medical examination record forms would be used depending on the type of response expected (that is, confidential or non-confidential responses). Preparation of survey tools would depend on survey population, which includes nurses in the institution within which evaluation exercise is to be carried out (Section 3, n.d). Another important factor that I would have to consider while designing survey items is the method I intend to use while administering the items.

For instance, self-administered instruments would be shorter and easier to be followed by the respondents without my presence. Also, use of questionnaires would be administered during internal conferences in order to minimize on costs and increase response rates. A part from population and delivery method factors, survey instruments would be developed with simplicity in language and questions (Section 3, n.d). Questions on sensitive information, such as age, education, ethnicity and marital status would be include at the end of the instrument (questionnaire), as they are likely to prevent effective responses from the nurses as these types of questions draws away respondents attention from main subject of the evaluation to their daily activities (Section 3, n.d). At times, some can become uneasy disclosing certain information. Therefore, while developing questionnaires, some questions (with little impact on the evaluation subject) would set with optional feedbacks.

Further, I will emphasize on the importance of the evaluation exercise by developing appropriate title for the questionnaires and relevant introductory elements in interviews (Section 3, n.d). Reliability and validity of the instrument would be measured after the first presentations.

The main qualitative methods to be used are participant anti-observation, interviews and focus groups. These methods would help in providing in-depth information about the impacts of the proposed solution to the nurses involved in the evaluation exercise and patients affected by the quality of services provided by the nurses.

Dissemination Plan

Dissemination process involves synthesis of data obtained and development of a detailed report, which is presented to stakeholders. The two strategies would be conducted concurrently and guided by four major factors. These include goals and objectives for dissemination exercise, target group for which the dissemination is meant for, the medium through which disseminated results would reach the target besides the timing of the dissemination exercise (YCCI, 2001). Effectiveness of my dissemination plan would be guided by three major considerations. These are proper utilization of resources in the process of development the plan, sensitivity to the needs of my audience in terms of objectivity, language and level of information besides adoption of relevant dissemination methods (YCCI, 2001).

Raw quantitative data obtained from the evaluation process would be analyzed using statistical tools (excel programme) and coordinated with other forms of data obtained through observations, interviews and discussion forums (qualitative technique) (Section 3, n.d).

These would then be compiled in two different dissemination documents. The research summary document would present key conclusions from the various evaluation stages (YCCI, 2001). In order to achieve this goal, I will develop the document with two sub-sections. The first section will present key findings in summary or points, which will be discussed using subsequent paragraphs with reference to numerical data, graphs or tables. The second section will contain detailed analytical facts-sheets, which will be used to measure effectiveness of the entire evaluation plan and success of the proposed solution offered (YCCI, 2001). Depending on consistency of the success realized (as would be indicated on summary documents), a policy brief would be developed. This is meant to inform the institution’s  stakeholders on the possible changes that would be necessary in improving service delivery through upgrading of skills, staff and client satisfaction, reduction of errors in nursing practices and quality matters (YCCI, 2001; Kohn et al 2000; Institute of Medicine, 2001).

Actual release of the two dissemination strategies would be done during an internal meeting with relevant stakeholders.

Review of Literature

In the modern health care system, the nurse plays a fundamental purpose of ensuring surgery of patients is safe. Medication is one of the most significant factors that ensure there is a positive outcome in every condition diagnosed. The literatures reviewed indicate that medication errors can occur in any health care setting, especially surgery. Shocking statistics are presented clearly to demonstrate the contemporary nature of the problem. Moreover, it is arguable that harm has been done to patients undergoing knee surgery and that much of the harm is preventable. Medication error as a problem is comprehensive and not exclusive to particular sectors in health care. In addition, the literatures address the standards that are applicable in reducing such startling statistics. Nonetheless, the role that nurse education play, especially for the nursing practice teams handling surgery patients should be valued. Educational measures and clinical strategies used together pose a potential yield in the general health setting with positive results possible in fighting medication error in patient care.

The synergy of education on the recognition, resolution, and prevention of medication error during surgery offers a potential opportunity in comprehensively managing the problem from a holistic perspective. There are relative education programs implemented to ensure nurse practitioners charged with the responsibility of administering medication do not make mistakes. Education has an imperative function in the prevention of medication errors during surgery sessions. As the literatures argue out, it is of significance for the nurse practitioners to acquire and maintain competency in their practice since medication management is crucial in the elimination of mistakes when administering medication. From the perspective of the contemporary nursing and the progressive nature of the professional development, education plays a strategic role in ensuring there are minimal cases of medication errors experienced, and the level of competency is enhanced. Such tailored education in cases of nursing medication management has fundamental foundations established at the earliest time possible in a nurse practitioners career. It continues beyond the pre-registration level.

The report by Cleary-Holdforth et al (2013) helps in analyzing the strategic role that education play in preventing errors during medication in a healthcare setting that handle surgery cases. Pragmatic proposals are presented in relation to the solutions that the study will focus on reducing medication errors in nursing. Moreover, the article evaluates how education assists in preparing nurse practitioners for their specific roles in ensuring a reduction of errors, enhanced patient care, and outcome in the general health care system.

Research Results

The report sheds light on the fundamental role that education plays in the eradication of the medication error problem, especially with the nurse practitioners handling knee surgery patients. Education is considered a potential factor in both clinical and academic settings in the preparation of nurse practitioners for specific roles in medication administration and marking reduction in errors to enhance surgery patient outcomes in such healthcare area of practice. From the article, the major area identified to cause medication errors is the inability of nurse practitioners accurately to calculate drug dosages that include ratios, multiplying factions, and information interpretation. The statistics presented in the article indicates that up to 10 percent errors in medication occur as a result of miscalculation. The report concludes that nursing competency in medication calculation forms part of an integrated process to ensure safe medication to surgery patients. Causes of deficiency in such skills pose risk to knee surgery patients as there is the probability of medication errors that may result to harm.

Significance to Nursing and Patient Care. From the literature, the article presents, medication error in nursing practice is a general interest, and the implementation of strategies meant to assist in curbing it is a concern for the overall health care system globally. The report suggests the significant ways through which the problem can be solved. The author argues that addressing the problem should involve every professional group in the health care sector that relies on nurse practitioners to handle medication administration to surgery patients. This would necessitate focusing on the problem itself, scrutinizing every practice in the area, and identifying the potential factors that contribute to the problem with an effort to address possible solutions. This is vital to nursing practice and patient care, following the practical aspects addressed with an initiative of reducing nurse practitioners contribution to the multi-disciplinary concern. It is of significance for the nurses to be open to the initiatives proposed to ensure a successful nursing practice.

Chang and Mark’s article investigates the concept of medication error in nursing practice through evaluating its background. The article uses a longitudinal study in providing statistical data to evaluate the significance of the medication error problem in the United States health care system. The article argues that severe and non-sever medication errors indicate different antecedents. It concludes that prevention studies as part of nursing should be implemented to assist in improving nursing practice.

Research Elements

The research design used in the article is a longitudinal study that included 6-month data collection from 146 hospitals and 279 nursing units selected randomly from health institutions in the US. Moreover, the study methods associated work environmental aspects, person aspects including experience and training, team factors, such as communication, patient factors, and medication support services like previous hospitalization records and health status. In the study, the research data used was obtained from a multisite organizational study that investigated the associations among the internal and external environments of a healthcare setting, working conditions, staffing adequacy, and patient outcome. 146 hospitals were used for the study for six months randomly with each having two medical, surgical specialties. Three questionnaires were used to collect data on nurse practitioners experience, education, expertise in medication, and work dynamics. The study involved ten randomly selected patients from every nursing unit to provide data during the end of the data collection period.

The study involved the use of both dependent and independent variables. The dependent variables conceptually defined medication error in nursing practice as a mistake incurred during medication administration rather than medication prescription. Numbers of errors in medication were measured over the six months of data collection. The data were primarily retrieved from major incident reports from the health care institutions used. The errors that resulted from cases of technical tests or enhanced nursing observation were registered under the severe medication errors notion with the rest registered as non-severe error. With the independent variables, the nurse practitioners work dynamism measurement was done through a Likert-form questionnaire. This involved questions on the characterization of nursing units with regular interruptions. The scale used involved an anchorage on six response options that ranges from a strongly agree strongly to disagree. The higher scores in the study indicated the significant work dynamics.

Research Results. In the study, the expertise of the nurse practitioners had a negative relation with the medication errors while medication administration-related support had a positive relation with similar medication errors. Moreover, the education level of the nurse practitioners indicated a potential nonlinear association with severe type medication errors. In addition, the article indicates that the increment in the number of competent nurses led to a corresponding decrease in medication errors.

Significance to Nursing and Patient Care. The study proves that medication errors classified as severe and non-severe both play a significant role that has different antecedents. Nonetheless, this has both nursing and patient care relevance as medication error prevention and management concepts are analyzed to match the particular types of error aforementioned for overall health care system best results.

Based on a pediatric inpatient environment, the Gorman et al.’s (2003) article reviews the significant steps that should be considered to assist in avoiding any medication error. The report does not provide statistical data to elaborate on the significance of the problem, but highlights the basic rate of error occurrence in the general healthcare sector. According to Gorman, in ensuring cases of medication error are minimal, healthcare environments should have effective programs that can handle reported error occasions based on the competency of nurse practitioners.

In Wood et al.’s (2002), it is observed that nurses have been playing a significant role in the reduction of errors in medication. The article provides statistical data for categorizing errors, and demonstrates the significance of handling the problem efficiently. The report supports the proposed changes to ensure the aspect of medication error is minimized.

Payne et al (2007) addresses the problem as a common factor in nursing practice. It provides data to exhibit the significance of reducing medication errors based on records from databases. The author uses descriptive statistics in comparing data sets to support the proposed solutions to the issue after highlighting the different causes known to practitioners.

The article by Primejdie et al (2014) focuses on the medication patterns as applied in Romanian nursing homes. Medical statistical data from clinical pharmacists are reviewed to demonstrate the significance of the problem. The article supports some of the aforementioned proposed changes meant to ensure medication errors are minimal in nursing.

In Beyea et al.’s (2003) article, the aspect of errors in medication in the operating room is discussed with a focus on nurse practitioners. It provides statistical information from a collective secondary study report from USP and AORN. The findings give an insight into the common medication errors in nursing and causes meant to assist in developing prevention strategies as proposed in the study.

This is further reinforced in Cohen’s work. In his article, Cohen (2004) argues that the most fundamental strategy considered in the healthcare system as a prevention measure for medication errors, especially when handling surgery patients is acknowledging that the process used in nursing administration, pharmacy dispensing, and prescriber ordering apply in the entire medication-use structure. The article uses statistical information in tables to show system failures in the medication administration process that result in cases of drug overdose and death. It concludes by providing vital safety strategies that should be considered as aforementioned in the study proposal.

Greengold et al.’s (2003) article addresses the possible impacts of dedicated medication nurse practitioners on the administration of medication and rate of errors. The study used random study statistical information from two hospitals with surgery setting to examine the significance of the medication problem, and how it can be decreased through dedicated nurses focusing on drug administration process. Moreover, the report proposes similar solutions to the research proposal by suggesting that the use of dedicated nurse practitioners in administering medication does not significantly contribute to error reduction compared to competent and educated nurses.

The study by Silen-Lipponen et al (2005) evaluates some of the most potential medication errors that occur in surgery rooms and the possible solutions as experienced by nurses in Finland, Britain, and America. The article uses statistical information collected using interviews and analyzed through qualitative analysis. The article concludes by proposing that balance of medication error-making should be first recognized as significant in order to learn from them. Moreover, this includes reporting of incidents and adopting a strategic reporting system to handle such cases.

Findings reported by Papastrat and Wallace (2003) address the significance of using the baccalaureate nursing curriculum in teaching students how to prevent medication errors through a problem-based learning approach.

This is in order to facilitate a transforming medication administration and error knowledge into practical concepts in a clinical setting. The report does not provide data to evaluate the significance of the problem but proposes that the aforementioned reinforcement will enable the nursing students to employ the critical skills necessary in developing confidence for safe, professional practice potential errors.

Cohen et al (2003) analyzes poll results from an investigation of nurse practitioners experiences and attitudes in relation to error in medication administration and reporting of such cases. The article does not provide any statistical data to evaluate the significance of the problem, but supports the proposed changes through discussing the potential implications. It concludes by providing more information on how making medication use a safer process in the health care system.

Also, Bednar and Latham’s article focuses on the aspects that have contributed to changing of the US Nephrology nursing care setting (2014). The study involves statistical information that focuses on the aspect of medication administering and nurse practitioner’s contribution to the growth of the healthcare system. The study notes the potential changes in nursing that have assisted in improving health care delivery noting the use of technology as a vital factor.

Kiersman et al.’s study (2009) evaluates the laboratory sessions that could be of significance in improving the awareness and self-confidence of first-year students in relation to the concept of preventing medication errors. It argues that the provision of active education experiences could assist recognize, resolve, and prevent medication errors. The study does not involve statistical information on the problem, but proposes that student awareness of their role in preventing and reducing medication errors through improving their confidence and ability on the subject matter is vital.

The study by Beyea (2002) asserts that standardization is a critical factor in the elimination of medication errors. Beyea proposes that the development of consensus and application of safe practice concepts of medication administering contributes to potential change nursing practice. However, despite other believing, they can be exempted from such measures. Nurse practitioners and clinicians should work together in ensuring the medication process is standardized and error-free.

References

Association of Operating Room Nurses. AORN Journal, 75 (5), 1010-1013.

Bednar, B., & Latham, C. (2014). The changing landscape of the Nephrology nursing care environment in the United States over the last 45 years. Nephrology Nursing Journal,

Beyea, S. (2002). Wake-up call–standardization is crucial to eliminating medication errors.

Beyea, S. C., Hicks, R. W., & Becker, S. C. (2003). Medication errors in the OR–a secondary analysis of medmarx. Association of Operating Room Nurses.AORN Journal, 77(1), 122-129, 132-134.

Chang, Y., & Mark, B. (2009). Antecedents of severe and non-severe medication errors. Journal of Nursing Scholarship, 41 (1), 70-78.

Cleary-Holdforth, J., & Leufer, T. (2013). The strategic role of education in the prevention of medication errors in nursing: Part 2. Nurse Education in Practice, 13 (3), 217-220.

Cohen, H. (2004). Pediatric medical errors part 3: Safety strategies medication use system to analyze errors. Pediatric Nursing, 30 (4), 334-335.

Cohen, H., Robinson, E. S., & Mandrack, M. (2003). Getting to the root of medication errors: Survey results. Nursing, 33(9), 36-45.

Gorman, R. L., Bates, B. A., Benitz, W. E., & Burchfield, D. J. (2003). Prevention of medication errors in the pediatric inpatient setting. Pediatrics, 112 (2), 431-436.

Greengold, N. L., Shane, R., Schneider, P., & Flynn, E. (2003). The impact of dedicated medication nurses on the medication administration error rate. Archives of Internal Medicine, 163 (19), 2359-2367.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press.

Kiersma, M. E., Darbyshire, P. L., Plake, K. S., Oswald, C., & Walters, B. M. (2009).

Knapp, T. R. (1998). Quantitative nursing research. Thousand Oaks, Calif: Sage Publications. Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer Health/lippincott Williams & Wilkins.

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.

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Appendix A: Sample Contact Forms

Fig. 1: Sample Contact Form

Source: http://www.cdc.gov/ncipc/pub-res/dypw/07_appendixb.htm

Fig. 2: Sample Form for Items Received

Source: http://www.cdc.gov/ncipc/pub-res/dypw/07_appendixb.htm

Fig. 3: Sample Form for Items Distributed

Source: http://www.cdc.gov/ncipc/pub-res/dypw/07_appendixb.htm