Nursing Capstone Project Paper on Review of Literature

Review of Literature

Introduction

            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.

Article analysis

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.

Summary of Article

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

Summary of Article

            This 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.

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.

            Based on a pediatric inpatient environment, the 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.

Woods, A., & Doan-Johnson, S. (2002). Executive summary: Toward taxonomy of nursing practice errors. Nursing Management, 33 (10), 45-48.

            The article argues 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, C. H., Smith, C. R., Newkirk, L. E., & Hicks, R. W. (2007). Pediatric medication errors in the post anesthesia care unit: Analysis of MEDMARX data. Association of Operating Room Nurses. AORN Journal, 85 (4), 731-740

            The article 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.

Primejdie, D. P., Bojita, M. T., Revnic, C., & Popa, A. (2014). Patterns of medication use among Romanian nursing homes residents. Pharmacology & Pharmacy, 5 (6), 560-569.

            The article 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.

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.

            In this 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.

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

            In the article, Cohen argues that the most fundamental strategy considered in the health care 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, 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.

            This 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.

Silén-Lipponen, M., Tossavainen, K., Turunen, H., & Smith, A. (2005). Potential errors and their prevention in operating room teamwork as experienced by Finnish, British and American nurses. International Journal of Nursing Practice, 11 (1), 21-32.

            The study 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.

Papastrat, K., & Wallace, S. (2003). Teaching baccalaureate nursing students to prevent medication errors using a problem-based learning approach. Journal of Nursing Education, 42 (10), 459-464.

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

            In this article, Cohen 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.

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, 41(2), 183-90.

            The article focuses on the aspects that have contributed to changing of the US Nephrology nursing care setting. 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.

Kiersma, M. E., Darbyshire, P. L., Plake, K. S., Oswald, C., & Walters, B. M. (2009). Laboratory session to improve first-year pharmacy students’ knowledge and confidence concerning the prevention of medication errors. American Journal of Pharmaceutical Education, 73(6), 1-99.

            This study 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.

Beyea, S. (2002). Wake-up call–standardization is crucial to eliminating medication errors. Association of Operating Room Nurses. AORN Journal, 75 (5), 1010-1013.

            This study argues 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.

Incorporating Theory