Nursing Research: Reading, Using, and Creating Evidence, Research Paper Example

Clinical Question     

The focus of this research will be to determine how the occurrence of medical errors can be reduced. Each year, more than 400,000 Americans die as a consequence of medical errors (James, 2013). It is therefore necessary for all health care professionals to collaborate in a manner that can effectively reduce the frequency of these errors (Houser, 2015). While many efforts have been put in place by health care institutions to increase the quality of care that patients receive, many of these initiatives have not been effective or have not been as effective as initially predicted. Therefore, it is necessary for these organizations to assess the interventions that they are currently using and how they can be altered based on collected data. This problem is significant because many of the deaths that occur within health care organizations across the country are preventable. Furthermore, many injuries can be prevented as well. Since approximately half of all accidents have been deemed to be preventable, it is necessary for health care professionals to become actively involved in preventing such tragedies.

The following PICOT question is therefore proposed:

Will patients in the state benefit from nurses checking patient records at least twice before providing them with medication and thoroughly recording information related to medication application including the method of delivery, dose, type of drug, and timing, and is this practice able to reduce medication errors by at least 10% compared to the standard of care in a 6 month period?

Population: All nurses in the state.

Intervention: Checking patient records at least twice before providing them with medication and thoroughly recording information related to medication application including the method of delivery, dose, type of drug, and timing.

Comparison: Checking patient records once before providing them with medication and recording only the information that appears necessary.

Outcome: A reduction of medication error by 10%.(James, 2013)

Time: 6 months. (Persell & Elder, 2013)

The purpose of this paper is to provide an intervention that hospitals will be able to implement in order to reduce the frequency of medication errors. By thoroughly examining patient records kept in the electronic health record system, interviewing patients, and tracking the application of medication, this goal should be achievable.

Levels of Evidence

The type of question that is being asked in this situation is determining how nursing practices can be altered to better treat patients. Therefore, this question is related to nursing education and the implementation of nursing best practices. Nurses are uniquely responsible for altering the quality of care that patients at their institution receive because they spend more time with patients than the physicians (Houser, 2015). As a consequence, a majority of medication errors result due to faulty reporting or application, which falls within the nurse’s domain. Since nurses are more likely to make these errors, they are equally responsible in ensuring that these mistakes do not occur.

The best type of study that could be used to answer this question is a quantitative study that compares baseline medication error information prior to the intervention to medication error data after the intervention (Houser, 2015). However, the study will also need to incorporate qualitative techniques that will allow nurses to self-assess their performance, as a majority of medication errors go unreported in the hospital. All participating nurses will be provided with a particular protocol that they are expected to follow when working with a patient and applying medication. They will be asked to check the patient’s medical record two separate times, confirm all demographic information, and upon delivery, thoroughly record information related to medication application including the method of delivery, dose, type of drug, and timing. The efficacy of this intervention will be determined by using statistical testing to determine whether there was a significant change in medication errors compared to the baseline percentage measured. A mixture of hospital records and an initial nursing survey will be used to determine the amount of medical errors that nurses have made in the previous six months. The follow up survey will ask the same question. A 10% reduction in medication errors is necessary during this six month period in order to consider the intervention as a success.

Search Strategy

Databases such as Google Scholar and PubMed were used to conduct a literature review for this study. This search yielded articles from the Journal of Patient Safety, the National Institute of Health Care Reform, and the Journal of the American Heart Association. Search terms such as “medication” and “error” were included. Furthermore, articles studying the relationship between electronic health record systems and medication errors were examined. As such, the terms “electronic health record system” and “EHR” were used as well. Articles were sorted to only include publications that have been released in the last 4 years.

In order to refine the number of articles I received, I used only those from journals and research organizations that I have heard of prior to conducting this research. In addition, I aimed to select only those that provided either background information about medication errors, such as demographic or public health analyses, or the articles that demonstrated the relationship between electronic health record systems and medication errors. Furthermore, I preferentially selected the articles that had been published more recently.

The two most important articles I uncovered were “Hospital Experiences Using Electronic Health Records to Support Medication Reconciliation” and “A new, evidence-based estimate of patient harms associated with hospital care” (Grossman et al., 2014). “Hospital Experiences Using Electronic Health Records to Support Medication Reconciliation” was beneficial because it provided me with information about the use of electronic health record systems as it pertains to fixing medication error mistakes, while “Hospital Experiences Using Electronic Health Records to Support Medication Reconciliation” was beneficial because it provided useful statistics regarding the amount of medication errors that occur in the country each year, allowing me to understand the full scope of the problem (Persell & Elder, 2013).

Conclusion

In conclusion, it is important to address preventable medication errors, as 50% of all related deaths are preventable. Nurses are the first line of protection that the patient has available and must therefore act accordingly. It is necessary to implement new practices to ensure that patients will receive excellent care regardless of the hospital that they visit. In order to prevent these mistakes, it would be beneficial for health care professionals to double check patient records prior to administering medication and to verify the accuracy of this information. If all nurses agree to follow this protocol, it may be possible to reduce the percentage of medical errors that occur within an institution by 10% in a period of six months. In order to ensure that this will be possible, it will be necessary for all health care professionals to work together closely to make sure that this quality of care problem can finally be resolved. If this project is successful, it would be reasonable to attempt to decrease the amount of medication errors by 15% since the beginning of the project in the six months to follow the completion of this first project phase.

References

Grossman J.M., Gourevitch, R., Cross D.A. (2014). Hospital Experiences Using Electronic Health Records to Support Medication Reconciliation. National Institute for Health Care Reform, 17: 1-12.

Houser, J. (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury, MA: Jones and Bartlett.

James, J.T. (2013). A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf., 9(3): 122-8.

Persell, S.D., Elder, M. (2013). Health Services and Outcomes Research. JAHA, doi: 10.1161/JAHA.113.000311