A Qualitative Critical Incident Study, Research Paper Example

Problem Statement

In Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study, the authors aim to determine the cause of intravenous medication administration (MAEs) in a series of affiliated hospitals (Keers et al., 2015). However, the information derived from this research study is expected to be applicable in most heath care settings. The study was initiated after health care professionals noted that there is a high rate of MAE in the health care setting, despite the fact that these cases are seemingly preventable. The researchers cite a broad range of medication errors as the reason this research project was initiated.

Specifically, the researchers are concerned that 1.8% of hospitalized patients are impacted by preventable adverse drug events. Furthermore, this incidence is considered to be preventable because all MAEs are related to human error. It is possible that practices could be enhanced by ensuring a higher degree of staff supervision, providing enhanced training, and minimizing distractions. Overall, it is important for the cause of MAEs to be more thoroughly understood because the incidence of medication errors detracts from the overall quality that health care providers are able to offer. Determining the cause of intravenous MAEs specifically will help provide the health care administration with insight that will help it refine its practices to ensure that the quality of care that it offers its patients will continue to improve. Furthermore, this approach is advantageous because it considers the possibility that different categories of medication errors can be caused by different factors. Understanding the specific factors caused by each will result in more personalized solutions to these problems.

The author established the significance of the study by explaining that that there are very few studies available that focus on intravenous MAEs. Therefore, if they are able to find helpful results that can direct health care practice, they are able to demonstrate the importance of considering the impacts of medication errors on a case by case basis, rather than considering these issues to be a bulk problem. Ultimately, this plan is expected to reduce human suffering as a consequence of these mistakes in addition to the number of patients who are adversely impacted by these intravenous medication errors.

Purpose and Research Questions

The purpose of the study is to reveal information about intravenous MAEs using the “critical incident technique (CIT) within semistructured interviews to investigate the underlying causes of intravenous MAEs in two National Health Service (NHS) hospitals” (Keers et al., 2015). The survey was designed to link the demographics and individual experiences of participating nurses to factors that result in intravenous MAEs. The first section of the survey asked nurses to describe their training background as it pertained to intravenous medication administration, the number of years they worked as a qualified medical professional, and their area of practice. To uncover specific information about the types of medication errors that occurred, participating nurses were then asked to report the details of the medication error including how it was discovered and whether it impacted the patient, the reasons for the mistake, and the circumstances of the mistake. Last, they were asked to reflect on the error made, what if any changes were made to their professional practices, and how the incident could have been prevented. This information was compiled to determine how the medication errors occurred in addition to what has and could be done to prevent them from occurring in the future.

Ultimately, it is apparent that the purpose and research questions were related to the problem because together, the survey questions could be used to determine the cause of the intravenous MAEs. Since the research study was primarily concerned with the professional practice of the nurse, it could be said that qualitative methods were an appropriate method to answer the research question. This method allows the researchers to retrieve data concerning specific situations in which medication errors had occurred. A similar understanding would not be possible if quantitative methods had been used.

Literature Review

While the author cited both quantitative and qualitative studies that were relevant to the study, a majority of the references used were in the form of systematic reviews and meta-analyses. There has been a lot of information generated concerning medication errors, so the authors believed that this information would be best summarized by providing references to these review studies. These studies were useful for the discussion of medication errors in general, as very few studies have specifically assessed the utility of intravenous MAEs. The several research studies that do discusses intravenous MAEs, however, were both quantitative and qualitative in nature and cited in this research study.

A majority of the references used were recent within the past five years, although some renowned books on the topic that were published more than 15 years ago were used. Peer-reviewed journal articles that were utilized and exceeded the 5-year limit were qualitative in nature and therefore applicable to this study. In particular, the only intravenous MAE studies available were published more than 5 years ago, making it necessary for the authors to have included these publications as references. However, the author did not attempt to evaluate or indicate the weaknesses of a majority of the available studies, with the exception of the intravenous MAE studies used to indicate a need to build upon the findings these researchers were able to yield. There was not a standalone literature review section present in this study. Rather, the references were integrated into the introduction and discussion to support the rationale for the study and to support the conclusions drawn.

Conceptual / Theoretical Framework

The authors mentioned that this study derived from the need to generate a better understanding of intravenous MAEs. Furthermore, the study was based on Reason’s model of accident causation, which states that high level decisions and processes contribute to error and violation producing conditions, which contribute to active failures that are occasionally able to bypass defenses and cause medication errors. While framework was not developed from the study findings, it is important to consider that this model is applicable to the situation and could also be used to gain a greater understanding of the results. Overall, this model could be used to allow the hospital administration to gain a better understanding of the types of intravenous medication errors made. According to the results, some errors were purposeful violations of the rules, while others were active failures, mistakes, and slips. Future researchers and practitioners can use this understanding in their own personal practice to improve the overall quality of their institution of employment. In order to fully understand this relationship, however, research should be conducted on an institutional basis.

References

Keers RN, Williams SD, Cooke J, Ashcroft DM. (2015). Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study. BMJ Open, doi:10.1136/bmjopen-2014-005948.