(mayayowa) Topic : Medication errors in the hospital. Question : (1)What are the most effective way to improve adult patient safety on medication errors among the newly qualified nurses in the...

IMPLEMENTING EVIDENCE BASED PRACTICE SUMMATIVE ASSIGNMENT
Table of Contents
Introduction    3
Research Question    3
Methodology    4
Results of the Search Strategy    5
Quality Appraisal    6
Article 1:    6
Article 2:    7
Article 3:    7
Article 4:    8
Article 5:    9
Article 6:    10
Summary and Synthesis of the Papers    10
Issues of Implementation    11
Conclusion    12
References    13
Appendix    14
1. Qualitative Study CASP    14
2. Cross-Sectional Study CASP    15
3. Cohort Study CASP    16
4. Systematic Review CASP    17
Introduction
Nurses are trusted to provide best possible care to the patients; however, nurses can also perform certain e
ors, which could be life threatening for the patient. Medication e
ors are one of the widely occu
ing preventable mistakes in healthcare industry and it can lead to severe physical injury as well as death of the patient (E
ahimipour et al, 2016; Flynn et al, 2016).). Medication e
or could be resultant from systematic issue or plain human e
or; however, i
espective of the cause, it can lead to severe physical injury and possible death of the patient.
As per Fathi et al (2017) analysis, medication e
ors are the most common health concern threatening or affecting patient care and these could result into increased mortality and increases healthcare expenditure. Newly qualified nurses or newly recruited nurses at the hospitals are more prone to perform medication e
ors through wrong dosage, medication route, giving medicine to wrong patient, wrong calculation and much more.
All of these result into threatened patient safety at the hospital along with a surge in patient dissatisfaction. Therefore, this paper would discuss medication e
ors performed by newly qualified nurses as a threat to patient safety. Further, efforts would be made to identity relevant literature concerning the actual cause behind research question and some effective ways to improve patient safety along with decreased medication e
ors at the hospital.
Research Question
It would be essential to understand that medication e
ors are one of the most common and highly preventable healthcare issues. There could be numerous rationales behind the occu
ence of medication e
ors and these are most common among newly appointed nurses. Providing patients with the required medications is one of the most critical and essential duties, which nurses have to perform. All members of the team concerning the healthcare providers or healthcare team could cause medication e
ors; however, nursing based medication e
ors are mostly common in newly hired ones. This is majorly because of the fact that nurses execute majority of the medical orders and they spend more than 40% of their time administering medications in the hospital.
As presented by Hammoudi, Ismaile and Abu Yahya (2018), major facilitators of medication e
ors involving nurses are related to packaging, pharmacy processes nurse-physician communication and lack of experience. Therefore, the criterion of the research question for this paper would be guided by the following inquiry:
‘What are the most effective ways to improve adult patient safety on medication e
ors among the newly qualified nurses in the hospital?’
PICO—
Population – In order to accomplish the course of research, the selected population will be newly qualified nurses.
Intervention – Decreased medication e
ors to improve adult patient safety.
Comparison - Experienced nurses possess the ability to confer challenges encountered during medicating the patients; however, new nurses confront complex situations like to counter the challenges and the fear of reporting as well as disagreements could drive them to medication e
ors. Further, it would be essential to note in the present context that the cu
ent literature provides enough evidences to support medication e
ors and inclusion of nurses in the cases; however, there is a lag of emphasis upon inclusion of new nurses leading to medication e
ors.
Outcomes – Increased patient safety and decreased risk of causalities.
Aims and objectives of this review paper would be—
· To identify medication e
ors and role of nurses
· To understand the involvement of nurses concerning types of medication e
ors
· To analyse the role of newly qualified nurses in increasing medication e
ors
· To establish a link between patient safety and medication e
ors
· To propose effective strategies in order to counter medication e
ors involving newly qualified nurses.
Methodology
Selection of papers to be included in the presented review was a complex and multi-step process. The database used for the retrieval of research papers was ‘Google scholar’. In order to continue with the search, research question was
oken into fragments and key words were identified as ‘medication e
ors’, ‘nurses’ and ‘patient safety’. These key words were shuffles and they were combined using Boolean ‘AND’. This resulted into around 55,000 search results. Therefore, in order to na
ow down the research, several filters were implied such as year of publishing was selected at 2016 and this removed papers older than 2016. Likewise, only peer reviewed papers were selected for this review and this na
owed down the research to only 21 papers.
Inclusion and exclusion criteria were implied where papers excluding the research terms were neglected. Moreover, papers that were not peer reviewed were also excluded. Therefore, in order to present an effective review, six papers were selected whose results and quality appraisals will be presented below.
Results of the Search Strategy
The results from above presented search strategy allowed identification of six research papers, which would be included in this review. Hammoudi, Ismaile and Abu Yahya (2018) mentioned that medication e
ors caused by nurses are majorly related to medication packaging, unclear medication dosage, workload, lack of staff and lack of experience among new nurses and poor communication between nurses and the physician. Therefore, it would be essential to understand that i
espective of nurse’s qualification or experience in the industry certain external factors could also be held responsible for occu
ence of medication e
ors.
Further, Bjorksten et al. (2016) mentioned that out of total identified 613 medication e
ors, the most common medication e
or was of wrong dosage, followed by administration of medication to wrong patient. Moreover, they also presented that negligence and lack of attentiveness from the nurses was one of the major contributory factors (68%) concerning the occu
ence of medication e
ors. Fathi et al. (2017) presented similar results from the hospitals of west Iran and as evident from the results presented by authors, it would be essential to consider that the increased prevalence of medication e
ors was associated with wrong administration at wrong time and dosage e
ors.
Moreover, these causative factors were more prevalent among newly appointed nurses, as they lacked experience and professional exposure. Likewise, new nurses did not report medication e
ors and was a reflected as a direct concern to patient safety. Fathi et al. (2017) proposed that reduction of staff workload and introduction of nurse’s training could ensure patient safety and reduction in medication e
ors.
Lee (2017) presented another major threat to patient safety accompanied with medication e
ors, which was not reporting medication e
ors. In other words, nurses were not reporting medication e
ors in incident report, which has been identified as serious threat to patient safety. Medication e
ors in most of the cases could be controlled or reversed; however, non-disclosure or non-filing of the incident clearly...